本文選題：喉腫瘤　切入點(diǎn)：癌　出處：《山西醫(yī)科大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：目的系統(tǒng)評(píng)價(jià)喉、下咽惡性腫瘤喉全切除術(shù)后咽瘺發(fā)生的危險(xiǎn)因素,以進(jìn)一步明確咽瘺發(fā)生的影響因素,有效預(yù)防該并發(fā)癥。方法以下咽、喉惡性腫瘤、喉全切除術(shù)和并發(fā)癥或因素或原因或病因,以及咽瘺、皮膚瘺等為主題詞全面檢索MEDLINE、EMBASE數(shù)據(jù)庫和中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫和重慶維普數(shù)據(jù)庫,按納入及排除標(biāo)準(zhǔn)納入?yún)⒖嘉墨I(xiàn),提取數(shù)據(jù),采用RevMan4.2軟件對(duì)納入文獻(xiàn)的數(shù)據(jù)進(jìn)行匯總分析(meta-analysis,Meta分析)。結(jié)果共納入26個(gè)臨床病例研究,病例總數(shù)4091,咽瘺發(fā)生例數(shù)684。。全部入選病例咽瘺總發(fā)生率為16.72%。Meta分析結(jié)果顯T3T4期患者咽瘺發(fā)生率高于T1T2期患者(OR 0.49,P0.0001)。氣切患者咽瘺發(fā)生率高于無氣切患者(OR 1.73,P=0.02)。術(shù)前接受放療患者咽瘺發(fā)生率高于未接受放療的患者(OR 3.39,P0.00001),聲門上(OR 2.49,P=0.0003)及跨聲門型(OR 2.50,P=0.03)喉癌患者咽瘺發(fā)生率高于聲門型患者。同期行頸淋巴結(jié)清掃患者咽瘺發(fā)生率高于未行頸清患者(OR1.58,P=0.002)。手術(shù)時(shí)間＞4小時(shí)者咽瘺發(fā)生率高于≤4小時(shí)患者(OR 2.95,P0.00001)。術(shù)后血紅蛋白≤120g／L時(shí)咽瘺發(fā)生率高于血紅蛋白＞120g／L(OR 2.03,P=0.0004)。合并全身疾病者咽瘺發(fā)生率高于未合并全身疾病患者(OR 6.56,P=0.0001)。結(jié)論病變部位、晚期腫瘤(T3、T4)、術(shù)前氣管切開、術(shù)前放療、合并頸淋巴結(jié)清掃、術(shù)后血紅蛋白小于120g／L、手術(shù)時(shí)間超過4小時(shí)及合并全身疾病是喉癌、下咽癌術(shù)后咽瘺發(fā)生的危險(xiǎn)因素。
[Abstract]:Objective to evaluate the risk factors of pharyngeal fistula after total laryngectomy for laryngeal and hypopharyngeal malignant tumors, so as to further clarify the influencing factors of pharyngeal fistula and effectively prevent the complication. MEDLINE EMBASE database, Chinese biomedical literature database, full text database of Chinese academic journals and Chongqing Weipu database were searched for total laryngectomy and complications or factors or causes or causes, as well as pharyngeal fistula and skin fistula. According to the criteria of inclusion and exclusion, the data were extracted, and the data were collected and analyzed by RevMan4.2 software. The results were analyzed by meta-analysis and meta-analysis. The results were included in 26 clinical case studies. The total number of cases was 4091, and the total incidence of pharyngeal fistula was 684.The total incidence of pharyngeal fistula was 16.72.Meta-analysis showed that the incidence of pharyngeal fistula in patients with stage T3T4 was higher than that in patients with stage T1T2. The incidence of pharyngeal fistula in patients with pneumotomy was higher than that in patients without pneumectomy. The incidence of pharyngeal fistula in patients with radiotherapy was higher than that in patients without radiotherapy (OR 3.39, P 0.00001, OR 2.49, P = 0.0003) and transglottic type, OR 2.50 / P0. 03)) the incidence of pharyngeal fistula in patients with laryngeal carcinoma was higher than that in patients with glottic type, and the incidence of pharyngeal fistula in patients with neck lymph node dissection was higher than that in patients without neck dissection at the same time. The incidence of pharyngeal fistula in patients with operation time > 4 hours was higher than that in patients with less than 4 hours. The incidence of pharyngeal fistula in patients with postoperative hemoglobin 鈮，

本文編號(hào)：1567120