头颈部肿瘤放射治疗并发鼻窦炎临床分析.docVIP

头颈部肿瘤放射治疗并发鼻窦炎临床分析 　　[摘要] 目的 分析?^颈部肿瘤放射治疗并发鼻窦炎临床特征、疗效，总结防治经验。方法 方便选取2016年1月―2017年5月医院共收治头颈部肿瘤放射治疗并发鼻窦炎20例，所有对象都采用滴鼻剂、生活管理等方法预防鼻窦炎，参照《慢性鼻-鼻窦炎诊断和治疗指南》诊断，诊断后采用配置溶液进行鼻腔与鼻咽部冲洗，1～2次/d，直至放疗结束，结束后3～4次/周。结果 诊断时、放疗结束时、放疗后1周TNSS、TNNSS评分分别为（9.1±1.1）分、（4.4±1.1）分、（2.4±1.1）分，（5.5±3.5）分、（5.8±2.5）分、（2.5±1.0）分，呈持续下降趋势，差异有统计学意义（F=4.26、5.10，P=0.016、0.0060.05），放疗后1周，鼻塞等症状基本消失，部分对象仍然遗留鼻痒、偶发喷嚏等症状，不影响生活。放疗后1周后，内镜检查水肿发生率0.0%（0/20），低于诊断时100.0%（20/20），差异有统计学意义（χ2=40.00，P=0.0000.05），黏膜愈合较好，未见鼻漏、瘢痕形成等异常。结论 头颈部肿瘤放射治疗并发鼻窦炎需要综合管理，诊断后积极治疗，绝大多数症状可控制。 　　[关键词] 头颈部肿瘤；放射治疗；鼻窦炎 　　[中图分类号] R739 [文献标识码] A [文章编号] 1674-0742（2018）03（b）-0081-03 　　Clinical Analysis of Radiotherapy of Head and Neck Neoplasms Combined with Nasal Sinusitis 　　TANG Jie 　　Department of Ophthalmology and Otorhinolaryngology， Qidong Fifth People’s Hospital， Qidong， Jiangsu Province， 226231 China 　　[Abstract] Objective To analyze the clinical features and curative effect of radiotherapy of head and neck neoplasms combined with nasal sinusitis and summarize the prevention experience. Methods 20 cases of patients with head and neck neoplasms combined with nasal sinusitis in our hospital from January 2016 to May 2017 were convenient selected and all objects used the nasal drop and life management method to prevent the nasal sinusitis， according to the chronic rhino-sinusitis diagnosis and treatment guidance， and the nasal cavity and nasopharynx washing was conducted after diagnosis for 1-2 each time to the end of the radiotherapy， and 3-4 times each week at the end. Results The TNSS and TNNSS scores at diagnosis， at the end of radiotherapy and in 1 week after radiotherapy were respectively（9.1±1.1）points，（4.4±1.1）points，（2.4±1.1）points，（5.5±3.5）points，（5.8±2.5）points，（2.5±1.0）points， showing a continuous decreasing trend， and the differences were statistically significant，（F=4.26，5.10，P=0.016，0.006 　　[Key words] Head and neck neoplasm； Radiotherapy； Nasal sinusitis 　　头颈部肿瘤主要包括脑胶质瘤、甲状腺癌、脑转移瘤等，发生率15.22/10万，其中相当一部分为恶性肿瘤，因解剖位置比较特殊，手术根