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目的:分析鼻咽癌根治性放疗后鼻咽坏死的临床特点。方法:对12例鼻咽癌根治性放疗后鼻咽坏死的患者的资料、临床症状、治疗方式等特点进行分析与总结。结果:放射性鼻咽坏死的发生时间为放疗开始后6.0~28.0个月,中位时间为12个月(95%CI:6.8~15个月)。4例行鼻咽清创术者中有3例完全愈合,1例因鼻咽大出血死亡。8例保守治疗者,5例因鼻咽大出血死亡,3例仍健在。结论:鼻咽坏死与放疗技术、合并感染、个体耐受性、营养状态等相关。制订周密合理的放疗计划、保证患者营养状态及鼻咽部卫生状况、个体化治疗方案,有助于减少放射性鼻咽坏死的发生。鼻咽清创术能提高鼻咽癌放疗后鼻咽坏死患者的疗效。
Objective: To analyze the clinical features of nasopharyngeal necrosis after radical radiotherapy of nasopharyngeal carcinoma. Methods: The data of 12 patients with nasopharyngeal necrosis after radical radiotherapy of nasopharyngeal carcinoma, clinical symptoms and treatment methods were analyzed and summarized. Results: The time of radioactive nasopharyngeal necrosis was 6.0-28.0 months after the start of radiotherapy. The median time was 12 months (95% CI: 6.8-15 months). 3 of 4 routine nasopharyngeal debridement patients healed completely, and 1 died of nasopharyngeal hemorrhage. 8 cases of conservative treatment, 5 cases of death due to nasopharyngeal hemorrhage, 3 cases still alive. CONCLUSIONS: Nasopharyngeal necrosis is associated with radiotherapy, co-infection, individual tolerance, nutritional status and so on. Develop a well-planned radiotherapy plan to ensure that patients with nutritional status and nasopharyngeal health status, individualized treatment programs, help to reduce the occurrence of radioactive nasopharyngeal necrosis. Nasopharyngeal debridement can improve the efficacy of nasopharyngeal necrosis in patients with nasopharyngeal carcinoma after radiotherapy.