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目的探讨喉癌术后继发颈部出血的临床危险因素。方法选择2009年2月至2012年3月收治的喉癌患者150例,所有患者都采用环状软骨上喉部分切除术,对并发症与随访预后生存情况进行调查分析。结果所有患者均得到随访,生存率为96.7%。发生并发症15例,其中有5例为继发颈部出血。单因素分析显示,肿瘤部位、肿瘤T分期、颈淋巴结转移、先期气管切开、颈部淋巴结清扫术和术前术后放射治疗能影响喉癌术后继发颈部出血(P<0.05)。多因素分析显示,肿瘤部位、肿瘤T分期与颈淋巴结转移为主要的独立危险因素(P<0.05)。结论环状软骨上喉部分切除术应用于喉癌治疗能取得比较好的效果,但是容易导致术后继发颈部出血,多与患者的肿瘤部位、肿瘤T分期与颈淋巴结转移有关,为此要在手术前对患者进行合理评估。
Objective To investigate the clinical risk factors of secondary cervical hemorrhage after laryngeal cancer surgery. Methods 150 patients with laryngeal cancer who were treated from February 2009 to March 2012 were selected. All patients underwent partial laryngectomy and investigation of the complication and follow-up prognosis. Results All patients were followed up with a survival rate of 96.7%. Complications occurred in 15 cases, of which 5 cases of secondary neck bleeding. Univariate analysis showed that tumor location, tumor T stage, cervical lymph node metastasis, early tracheotomy, cervical lymph node dissection and preoperative and postoperative radiotherapy could influence the secondary neck hemorrhage after laryngeal cancer (P <0.05). Multivariate analysis showed that tumor location, tumor T stage and cervical lymph node metastasis as the main independent risk factors (P <0.05). Conclusion The application of partial laryngectomy for the treatment of laryngeal carcinoma can achieve good results, but it is easy to cause postoperative secondary neck bleeding, which is related to the location of the tumor, tumor T stage and cervical lymph node metastasis. Therefore, Patients should be properly evaluated before surgery.