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目的:评价下颌下腺移位预防鼻咽癌放疗后口干燥症的长期疗效。方法:65例鼻咽癌患者随机分为试验组32例和对照组33例。试验组在行常规放疗前将下颌下腺移位至颏下区,放疗时颏下区设置挡块。2组患者放疗前行下颌下腺造影检测下颌下腺功能,放疗后60个月采用99mTc核素扫描检测放疗后下颌下腺功能并进行口干程度问卷调查,且统计5年生存率。结果:放疗后60个月试验组下颌下腺摄取及分泌功能均明显较对照组好,差异均有统计学意义(P<0.01);试验组中度至重度口干燥症的发生率亦显著低于对照组,分别为15.4%和76.9%(P<0.01);试验组和对照组的5年生存率分别为81.3%和78.8%,两者之间差异无统计学意义(P>0.05)。结论:下颌下腺移位预防鼻咽癌放疗后口干燥症的长期疗效较好,可改善鼻咽癌患者放疗后的生存质量,不影响鼻咽癌的远期疗效。
OBJECTIVE: To evaluate the long-term efficacy of submandibular gland displacement in preventing xerostomia after radiotherapy of nasopharyngeal carcinoma. Methods: Sixty-five NPC patients were randomly divided into experimental group (32 cases) and control group (33 cases). In the experimental group, the submandibular gland was transplanted to the submental area before radiotherapy and the block was set in the submental area during radiotherapy. The submandibular gland function was detected by radiography in submandibular gland before radiotherapy in two groups. The function of submandibular gland after radiotherapy was measured by 99mTc radionuclide scanning 60 months after radiotherapy and the 5-year survival rate was calculated. Results: The uptake and secretion of submandibular gland in the experimental group at 60 months after radiotherapy were significantly better than those in the control group (P <0.01). The incidence of moderate to severe xerostomia in the experimental group was also significantly lower than that of the control group The control group were 15.4% and 76.9% respectively (P <0.01). The 5-year survival rates of the experimental group and the control group were 81.3% and 78.8% respectively, with no significant difference between the two groups (P> 0.05). CONCLUSION: The long-term effect of submandibular gland displacement in preventing the xerostomia after radiotherapy of nasopharyngeal carcinoma is good, which can improve the quality of life of patients with nasopharyngeal carcinoma after radiotherapy without affecting the long-term effect of nasopharyngeal carcinoma.