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目的观察颌下腺移位术预防鼻咽癌放疗后口咽干燥症的临床效果。方法2006年9月～2008年10月连续诊治的20例鼻咽癌患者中,选择符合入选标准的8例患者(试验组),于放疗前将颌下腺移位至颏下区,术后接受常规放疗,放疗中颏下区设置挡块以保护移位之颌下腺;其余12例(对照组)接受常规放疗。系统观察比较放疗中的急性口腔黏膜反应,并于放疗后3个月进行口干程度调查。结果试验组病例中,4例患者疗后无口咽干燥症状,4例患者疗后有轻微口干感觉;对照组12例皆口干症状。试验组和对照组放疗后唾液分泌量平均值分别为1.39g和0.68g,差异有统计学意义(P<0.01)。结论颌下腺移位术预防鼻咽癌放疗后口咽干燥症的近期疗效好,有利于改善患者放疗后的生活质量。
Objective To observe the clinical effect of submandibular gland transposition in preventing nasopharyngeal carcinoma after radiotherapy. Methods Eighteen nasopharyngeal carcinoma patients who were consecutively treated from September 2006 to October 2008 were selected to meet the inclusion criteria (experimental group). The submandibular glands were displaced to the infrapatellar area before radiotherapy. In radiotherapy and radiotherapy, a block was installed in the subphrenic area to protect the displaced submandibular gland; the remaining 12 patients (control group) received conventional radiotherapy. Systematic observations compared acute oral mucosal responses to radiotherapy and performed oral dryness investigations 3 months after radiotherapy. Results In the experimental group, 4 patients had no symptoms of oropharyngeal dryness after treatment, 4 patients had slight dry mouth feeling after treatment, and 12 patients in the control group had dry mouth symptoms. The average saliva secretion in the experimental group and control group after radiotherapy was 1.39g and 0.68g, respectively, and the difference was statistically significant (P<0.01). Conclusions The submandibular gland transposition can prevent oropharyngeal xerostomia after radiotherapy for nasopharyngeal carcinoma. It has good short-term curative effect and can improve the quality of life after radiotherapy.