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目的研究鼻咽癌患者放射治疗后的颈髓损伤状况。方法选择2013年1月至2014年10月间青岛市肿瘤医院收治的鼻咽癌放疗后出现放射性颈髓损伤(RICCI)的30例患者为研究组,以同期门诊随访的鼻咽癌放疗后经影像学检查及体格检查未发现RICCI的31例患者作为对照组,对两组患者进行MRI检查。结果放疗前两组患者感觉运动评分差异无统计学意义(P>0.05);放疗后研究组患者感觉运动评分低于对照组,差异有统计学意义(P<0.05)。研究组患者颈髓囊变的长度、横截面、体积明显大于对照组,美国脊柱损伤学会(ASIA)评分小于对照组(P<0.05)。放疗后,研究组B、C等级患者数明显高于对照组,D、E等级患者数低于对照组,差异均有统计学意义(均P<0.05)。结论鼻咽癌放疗可诱发RICCI,对患者的感觉运动、颈髓囊变的长度、横截面、体积均具有负面作用,加重患者的颈髓神经损伤,引起Frankle等级变化。
Objective To study the cervical spinal cord injury after radiotherapy in patients with nasopharyngeal carcinoma. Methods Thirty patients with radioactive cervical cord injury (RICCI) after radiotherapy of nasopharyngeal carcinoma admitted to Qingdao Tumor Hospital from January 2013 to October 2014 were selected as the study group. After the outpatient follow-up of nasopharyngeal carcinoma Imaging examination and physical examination 31 patients without RICCI were found as the control group, MRI examination of the two groups of patients. Results There was no significant difference in sensory movement scores between the two groups before radiotherapy (P> 0.05). After the radiotherapy, the sensory motion score of the study group was lower than that of the control group (P <0.05). The length, cross-sectional area and volume of cervical intramedullary in study group were significantly larger than those in control group. ASIA score was lower in the study group than in the control group (P <0.05). After radiotherapy, the number of patients with grade B and C in the study group was significantly higher than that in the control group, while the number of patients with grade D and E was lower than that in the control group (all P <0.05). Conclusion Radiotherapy can induce RICCI in patients with nasopharyngeal carcinoma, which has a negative effect on sensory movement, length, cross-section and volume of cervical cyst, aggravating the injury of cervical spinal cord and causing Frankle grade changes.