摘要
目的 分析咽后淋巴结转移放疗患者生存状况的危险因素.方法 采用回顾性分析研究法,对2020年1月—2022年1月期间武汉市第一医院收治的126例咽后淋巴结转移放疗患者展开研究,所有患者均随访至2022年11月,依据患者是否死亡将其分为死亡组(n=38)和存活组(n=88).对两组患者的各项一般资料和临床资料进行比较,对差异有统计学意义的因素进一步行Logistic多因素分析,明确咽后淋巴结转移放疗患者死亡的危险因素.结果两组患者的年龄、性别、BMI、吸烟、高脂血症、糖尿病、入院收缩压、入院舒张压、转移侧数情况比较差异无统计学意义(P＞0.05),两组患者的侧颈部淋巴结清扫史、TC、TG、LDL-C、HDL-C、尿酸、纤维蛋白原、血红蛋白、总胆红素、白细胞、血糖情况比较差异无统计学意义(P＞0.05).死亡组患者的最大径＞2 cm、舌骨下淋巴结、双侧转移、多个病灶、包膜侵犯、坏死、T3/T4分期、未/低分化、远处转移、单纯放疗的发生率均高于存活组,差异有统计学意义(P＜0.05).Logistic多因素分析双侧转移、包膜侵犯、未/低分化、单纯放疗为咽后淋巴结转移放疗患者死亡的危险因素(P＜0.05).结论 双侧转移、包膜侵犯、未/低分化、单纯放疗为咽后淋巴结转移放疗患者死亡的危险因素,临床中应对高危患者加强监测.
Abstract
Objective To analyze the risk factors of survival in patients with radiotherapy for postpharyngeal lymph node metastasis.Methods A retrospective study was conducted on 126 patients with radiotherapy for postpharyngeal lymph node metastasis admitted to our hospital from January 2020 to January 2022.All patients were followed up to November 2022,and were divided into death group(n=38)and survival group(n=88)according to whether they died.The general and clinical data of the two groups were compared,and the factors with statistical significance were further analyzed by Logistic multivariate analysis to identify the risk factors of death in patients with radiotherapy for postpha-ryngeal lymph node metastasis.Results There was no significant difference between the two groups in age,gender,BMI,smoking,hyperlipidemia,diabetes,admission systolic blood pressure,admission diastolic blood pressure,number of metastatic sides(P＞0.05),and there was no significant difference between the two groups in terms of lymph node clearance history,TC,TG,LDL-C,HDL-C,uric acid,fibrinogen,hemoglobin,total bilirubin,white blood cells,and blood glucose(P＞0.05).The incidence of maximum diameter＞2 cm,subhyoid lymph nodes,bilateral metastasis,multiple le-sions,capsule invasion,necrosis,T3/T4 staging,medium/high differentiation,distant metastasis and radiotherapy alone in the death group was higher than that in the survival group,with statistical significance(P＜0.05).Logistic multivari-ate analysis showed that bilateral metastasis,capsule invasion,medium/high differentiation and radiotherapy alone were risk factors for death in patients with retropharyngeal lymph node metastasis(P＜0.05).Conclusion Bilateral metasta-sis,capsule invasion,medium/high differentiation,and radiotherapy alone are risk factors for death in patients with ret-ropharyngeal lymph node metastasis.In clinical practice,high-risk patients should be strengthened monitoring.
NETL
NSTL
维普
万方数据