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1981年7月至1988年12月,作者为51例鼻咽癌放疗后颈淋巴结持续存在或复发的病人施行了根治性颈廓清术。病人年龄21～71岁,中数50岁,男36,女15,所有病人鼻咽和颈部均接受根治性放射剂量。手术后51人均存活,仅1例因手术后近距放疗引起颈部皮肤坏死,颈动脉破裂死亡。对50例存活病人的随访时间为6月～9年,中数2年,其中7例颈部复发,7例出现远处转移,3例在鼻咽部复发。3例伤口边缘坏死,需要二期手术关闭。2例有持续性乳糜漏,经保守治疗痊愈。对各种因素的分析结果表明,除颈淋巴结的移动性之外,病人的年龄、性别、颈淋巴结大小、数目、粘连
From July 1981 to December 1988, the authors performed a radical neck dissection in 51 patients with persistent or recurrent cervical lymph nodes after radiotherapy of nasopharyngeal carcinoma. Patients aged 21 to 71 years, median 50 years old, male 36, female 15, all patients received nasopharyngeal and cervical radiative dose. Survival of 51 patients survived, only 1 case of neck skin necrosis caused by brachytherapy and death of carotid artery rupture. Fifty survivors were followed up for 6 months to 9 years with a median of 2 years. Seven cases had neck recurrence, seven cases had distant metastasis, and three cases had nasopharyngeal recurrence. 3 cases of wound edge necrosis, requiring two surgical closure. 2 cases of persistent chyle leakage, cured by conservative treatment. Analysis of various factors showed that in addition to cervical lymph node mobility, the patient’s age, gender, cervical lymph node size, number, adhesion