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论文摘要

口腔癌患者术后吞咽障碍危险因素的系统评价

Systematic review of risk factors of postoperative dysphagia in patients with oral cancer

作者:卢倩, 郭柳媚, 毕小琴

Author:Lu Qian, Guo Liumei, Bi Xiaoqin

收稿日期:2021-08-19          年卷(期)页码:2022,40(3):328-328-334

期刊名称:华西口腔医学杂志

Journal Name:West China Journal of Stomatology

关键字:口腔癌,吞咽障碍,危险因素,系统评价,

Key words:oral cancer,dysphagia,risk factors,systematic review,

基金项目:四川省科技计划项目(2017KZ0022)

中文摘要

目的通过系统评价的方法探究口腔癌患者术后吞咽障碍的危险因素。方法检索中国知网、万方数据库、维普中文期刊数据库、中国生物医学文献服务系统、中国临床试验注册中心、PubMed、Cochrane library、Embase、Web of Science、Clinical Trials数据库,采用主题词结合自由词的检索方式,从建库至2021年6月,搜集口腔癌患者术后吞咽障碍危险因素的队列研究并进行质量评价,提取有效数据并运用RevMan 5.3软件进行分析。结果共纳入10篇文献,累计共有患者1 241例,其中暴露组473例,非暴露组768例。经合并效应量发现如下危险因素具有统计学意义,年龄(>60岁)、肿瘤生长部位(口咽、口底)、肿瘤TNM分期(T3、T4)、肿瘤临床Ⅳ期、肿瘤切除范围波及舌骨上肌或舌大部切除(>50%)、行颈淋巴清扫术、气管切开术、修复重建术、术后联合放射性治疗。结论现有证据提示,口腔癌患者术后吞咽障碍的危险因素包括:年龄>60岁、肿瘤位于口咽、口底、原发肿瘤为T3或T4、TNM分类Ⅳ期、肿瘤切除范围波及舌骨上肌或舌大部切除>50%、配合颈淋巴清扫术、气管切开术、修复重建术及术后联合放射性治疗。鉴于纳入文献的偏倚较少,敏感分析结论稳定且未受发表偏倚影响,该结论具有一定临床参考价值。

英文摘要

ObjectiveThis study aims to identify risk factors of postoperative dysphagia in patients with oral cancer by systematic review.

MethodsCohort studies in Chinese or English on risk factors of postoperative dysphagia in patients with oral cancer were searched from CNKI, Wanfang database, VIP Chinese Journal Database, China Biomedical Literature Service System, Chinese Clinical Trial Registry, PubMed, Cochrane Library, EMBASE, Web of Science, and Clinical Trials from the beginning to June 30, 2021. Subject words combined with free words were used to retrieve related articles. The included studies were evaluated, and the effective data were processed with Revman 5.3.

ResultsTen studies were selected, and they included 1 241 patients consisting of 473 patients in the exposed group and 768 patients in the control group. After the meta-analysis, the risk factors with statistical significance were as follows: age>60 years, tumor located in oropharynx or mouth floor, tumor size of T3 or T4, TNM stage of Ⅳ, resection involving suprahyoid muscle or tongue resection>50%, combination of neck dissection, tracheotomy, or reconstruction, and postoperative radiotherapy.

ConclusionAge>60 years, tumor in oropharynx or mouth floor, tumor size of T3 or T4, TNM stage of Ⅳ, resection involving suprahyoid muscle or tongue resection>50%, combination of neck dissection, tracheotomy, or reconstruction, and postoperative radiotherapy were significant risk factors of postoperative dysphagia in patients with oral cancer.

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