浙江医学
浙江醫學
절강의학
ZHEJIANG MEDICAL JOURNAL
2013年
18期
1656-1658,1663
,共4页
超声%颈动脉损伤%鼻咽癌%放疗
超聲%頸動脈損傷%鼻嚥癌%放療
초성%경동맥손상%비인암%방료
Ultrasound%Carotid injury%Nasopharyngeal carcinoma%Radiation
目的探讨超声检查在鼻咽癌放疗后颈动脉损伤中的应用价值。方法接受放疗并随访2年以上的鼻咽癌患者40例作为放疗组，对照组30例为新诊断还未实施放疗的鼻咽癌患者，应用彩色多普勒超声检查，记录患者颈动脉狭窄部位和狭窄程度，主要检测指标有：颈动脉管腔内径，内膜-中层厚度，斑块部位、大小、形态、回声及颈动脉血流情况，同时分析两组间相关危险因素对疾病的影响。结果两组间相关危险因素如年龄、性别、高血压、高脂血症、高血糖、吸烟等差异均无统计学意义（均P＞0.05），但两组间颈动脉损伤发生率差异有统计学意义（P＜0.05）。放疗组患者内膜-中层厚度明显大于对照组，发生狭窄情况远远高于对照组。颈动脉狭窄率＞50%仅见于放疗组。结论鼻咽癌患者放疗可导致颈动脉的内膜-中层厚度增加、形成斑块继而发生狭窄，而超声检查在颈动脉损伤的早期发现、早期预防及术后疗效评估中具有重要的临床应用价值。
目的探討超聲檢查在鼻嚥癌放療後頸動脈損傷中的應用價值。方法接受放療併隨訪2年以上的鼻嚥癌患者40例作為放療組，對照組30例為新診斷還未實施放療的鼻嚥癌患者，應用綵色多普勒超聲檢查，記錄患者頸動脈狹窄部位和狹窄程度，主要檢測指標有：頸動脈管腔內徑，內膜-中層厚度，斑塊部位、大小、形態、迴聲及頸動脈血流情況，同時分析兩組間相關危險因素對疾病的影響。結果兩組間相關危險因素如年齡、性彆、高血壓、高脂血癥、高血糖、吸煙等差異均無統計學意義（均P＞0.05），但兩組間頸動脈損傷髮生率差異有統計學意義（P＜0.05）。放療組患者內膜-中層厚度明顯大于對照組，髮生狹窄情況遠遠高于對照組。頸動脈狹窄率＞50%僅見于放療組。結論鼻嚥癌患者放療可導緻頸動脈的內膜-中層厚度增加、形成斑塊繼而髮生狹窄，而超聲檢查在頸動脈損傷的早期髮現、早期預防及術後療效評估中具有重要的臨床應用價值。
목적탐토초성검사재비인암방료후경동맥손상중적응용개치。방법접수방료병수방2년이상적비인암환자40례작위방료조，대조조30례위신진단환미실시방료적비인암환자，응용채색다보륵초성검사，기록환자경동맥협착부위화협착정도，주요검측지표유：경동맥관강내경，내막-중층후도，반괴부위、대소、형태、회성급경동맥혈류정황，동시분석량조간상관위험인소대질병적영향。결과량조간상관위험인소여년령、성별、고혈압、고지혈증、고혈당、흡연등차이균무통계학의의（균P＞0.05），단량조간경동맥손상발생솔차이유통계학의의（P＜0.05）。방료조환자내막-중층후도명현대우대조조，발생협착정황원원고우대조조。경동맥협착솔＞50%부견우방료조。결론비인암환자방료가도치경동맥적내막-중층후도증가、형성반괴계이발생협착，이초성검사재경동맥손상적조기발현、조기예방급술후료효평고중구유중요적림상응용개치。
Objective To evaluate the application of color Doppler flow imaging (CDFI) in detection of carotid injury of pa-tients with nasopharyngeal carcinoma after radiotherapy. Methods Forty patients with nasopharyngeal carcinoma after radiation (radiation group) and 30 newly diagnosed patients before radiotherapy (control group) underwent CDFI examination. The distri-bution of arterial stenosis and degree of stenosis were documented, with the parameters including vessel internal diameter, thick-ness of intima- media;position, size and shape of plaques, echo and blood flow of carotid artery. The results were compared be-tween radiation and control groups. Other risk factors of carotid injury were also analyzed in these two groups. Results There were no significant differences in age, gender, hypertension, hypercholesterolemia, hyperglycosemia and smoking between two groups(P>0.05). Carotid arterial injury was more common in radiation group than that in control group(P<0.05). The thickness of intima- media of the radiation group was larger than that of control group. The rate of stenosis in radiation group was higher than that in control group, and the significant stenosis (50%reduction of luminal diameter) was only found in radiation group. Conclu-sion Radiation may increase the thickness of intima- media and plaque formation, leading to significant carotid stenosis. Color Doppler flow imaging(CDFI) is of value in early detection of carotid stenosis.
