口腔疾病防治2026，Vol.34Issue(1)：65-74,10.DOI:10.12016/j.issn.2096-1456.202550339
86例头颈癌放疗后住院患者发生抢救事件的回顾性分析
A retrospective analysis of rescue events among 86 inpatients following radiotherapy for head and neck can-cer
摘要
Abstract
Objective To summarize the circumstances of rescue events in hospitalized patients after radiotherapy for head and neck cancer in order to provide a reference for clinical decision-making.Methods This study was ap-proved by the hospital's medical ethics committee.A retrospective analysis was conducted on the clinical data of 86 hospitalized patients admitted between 2015 and 2023 for oral and maxillofacial diseases following radiotherapy for head and neck cancer.Based on the occurrence of rescue events,patients were divided into a rescue group(n=20)and a non-rescue group(n=66).In addition,20 healthy subjects matched for age and gender with the rescue group were in-cluded as a control group.First,baseline characteristics were compared between the rescue and non-rescue groups.Sec-ond,a descriptive analysis of the clinical characteristics and rescue events of the rescue group patients was performed.Third,differences in laboratory inflammatory and nutritional indicators,as well as tracheostomy status,were compared between the rescue and non-rescue groups.Fourth,Dolphin Imaging software was used to measure cone beam computed tomography images of the rescue group,non-rescue group,and control group.Upper airway parameters were measured,including the sagittal and coronal diameters of the nasopharyngeal,palatopharyngeal,glossopharyngeal,and laryngopha-ryngeal segments.Results ① A comparison of baseline characteristics between the rescue and non-rescue groups showed no statistically significant differences in age,gender,or body mass index,but the proportion of patients with co-morbid pulmonary diseases was higher in the rescue group(P<0.05).② In the rescue group,the primary reasons for ra-diotherapy were nasopharyngeal carcinoma(65%)and tongue cancer(25%).The mean age was(54.75±11.59)years,with a male-to-female ratio of 3:1.The main reasons for this admission included radio-osteomyelitis in the mandible(55%)and recurrence of oral and maxillofacial tumors or new primary tumors in the oral and maxillofacial region(40%).The primary reason for rescue during hospitalization was dyspnea(55%),followed by acute massive hemorrhage(15%)and cardiac arrest(15%).Rescue events occurred mostly postoperatively(65%),with a median time of occurrence at 5 days post-operatively;30%occurred preoperatively,and 5%occurred intraoperatively.③ Laboratory indicators and tracheostomy status:preoperative and postoperative neutrophil counts,as well as the proportion of patients undergoing tracheostomy,were higher in the rescue group compared to the non-rescue group,while postoperative albumin levels were lower(P<0.05).④ Upper airway measurements:the coronal and sagittal diameters of the nasopharyngeal segment and the coronal diameter of the glossopharyngeal segment were smaller in both the rescue and non-rescue groups com-pared to the control group(P<0.001).Conclusion The data from this study indicate that hospitalized patients experi-encing rescue events after radiotherapy for head and neck cancer often have comorbid pulmonary diseases or tumor re-currence/new primary tumors,and frequently present with dyspnea.They exhibit a higher inflammatory state,poorer nu-tritional status,a greater need for emergency airway intervention,and share a common anatomical basis for dyspnea--upper airway narrowing.Clinical attention should be fully given to high-risk patients with these characteristics.关键词
头颈癌/口腔癌/鼻咽癌/放射治疗/放射性颌骨骨髓炎/抢救事件/呼吸困难/大出血/心脏骤停/气管切开术/上气道/锥形束CTKey words
head and neck cancer/oral cavity carcinoma/nasopharyngeal carcinoma/radiotherapy/osteora-dionecrosis of the jaw/emergency rescue event/dyspnea/massive haemorrhage/cardiac arrest/tracheotomy/upper airway/cone beam CT分类
医药卫生引用本文复制引用
廖燕玲,吴建霖,梁飞新..86例头颈癌放疗后住院患者发生抢救事件的回顾性分析[J].口腔疾病防治,2026,34(1):65-74,10.基金项目
广西重点研发计划项目(桂科AB24010269) This study was supported by the grants from Guangxi Key Research and Development Program(No.AB24010269). （桂科AB24010269）
