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目的探讨70岁以上高龄下咽癌患者安全有效的治疗方法。方法回顾性分析安徽医科大学第一附属医院耳鼻咽喉头颈外科共85例70岁以上高龄下咽癌患者住院治疗的临床资料。手术治疗组68例,非手术治疗组17例。Kaplan-Meier法计算生存率,用卡方检验比较两组并发症发生率和拔管率。结果手术组和非手术组患者5年生存率分别为38.2%(26/68)和5.9%(1/17),差异有统计学意义(P=0.005)。手术组中70~75岁年龄组和>75岁年龄组的5年生存率分别为38.6%(17/44)和37.5%(9/24),差异无统计学意义(P=0.26)。68例手术患者中45例行喉功能保留术,术后均恢复呼吸、吞咽和发音功能;23例未保留喉功能,术后均恢复呼吸和吞咽功能。手术患者并发症发生率为41.2%(28/68),70~75岁和>75岁年龄组的并发症发生率分别为38.6%(17/44)和45.8%(11/24),差异无统计学意义(P=0.56)。70~75岁和>75岁年龄组的拔管率分别为61.4%(27/44)和62.5%(15/24),差异无统计学意义(P=0.93)。结论高龄下咽癌患者根据其全身状况及肿瘤的侵犯范围选择适当的手术方式是可行、安全有效的。
Objective To investigate the safe and effective treatment for patients with hypopharyngeal cancer over 70 years of age. Methods A retrospective analysis was performed on the clinical data of 85 cases of hospitalized patients with hypopharyngeal cancer over 70 years of age who were admitted to the Department of Otolaryngology and Head and Neck Surgery at the First Affiliated Hospital of Anhui Medical University. There were 68 cases in the surgical treatment group and 17 cases in the non-surgical treatment group. Kaplan-Meier method was used to calculate the survival rate. Chi-square test was used to compare the incidence of complications and extubation rate between the two groups. Results The 5-year survival rates of patients in the surgical and non-surgical groups were 38.2% (26/68) and 5.9% (1/17), respectively. The difference was statistically significant (P=0.005). The 5-year survival rates in the 70 to 75-year-old and >75-year age groups in the surgery group were 38.6% (17/44) and 37.5% (9/24), respectively, with no statistically significant difference (P=0.26). Thirty-five of the 68 patients who underwent laryngeal function retention were recruited and all recovered breathing, swallowing, and pronunciation after surgery. In 23 cases, laryngeal function was not preserved and both respiratory and swallowing functions were restored after surgery. The incidence rate of complications in surgical patients was 41.2% (28/68). The complication rates in the 70-75-year-old and >75-year age groups were 38.6% (17/44) and 45.8% (11/24), respectively. Statistical significance (P=0.56). The extubation rates in the 70-75-year-old and >75-year-old age groups were 61.4% (27/44) and 62.5% (15/24), respectively, with no statistically significant difference (P=0.93). Conclusion It is feasible, safe and effective for elderly patients with hypopharyngeal carcinoma to choose appropriate surgical methods based on their general conditions and the extent of tumor invasion.