CAJ | 학술논문

目的：探讨鼻咽癌患者在综合治疗中发生严重放射性口腔黏膜炎的相关因素，寻找相应的早期预防和干预措施，并建立发生严重口腔黏膜炎的预测模型，为临床治疗提供参考。方法对221例鼻咽癌患者的10项临床指标进行单因素分析和多因素COX回归分析，根据COX回归分析结果建立预后指数（ PI）方程，并按PI值将患者划分为严重口腔黏膜炎高发组和低发组，比较其口腔黏膜炎发生率的组间差异。结果多因素COX回归分析提示同步放化疗、口腔护理差、采用常规放疗方法是发生严重口腔黏膜炎的高危因素， PI值＞0．2201的患者严重口腔黏膜炎发生率高于PI值≤0．2201患者，差异有统计学意义（ P＜0．01）。结论同步放化疗、口腔护理差、采用常规放疗方法是发生严重口腔黏膜炎的高危因素。 PI值能较好地预测严重放射性口腔黏膜炎的发生，为临床进行预防和治疗提供参考。
목적：탐토비인암환자재종합치료중발생엄중방사성구강점막염적상관인소，심조상응적조기예방화간예조시，병건립발생엄중구강점막염적예측모형，위림상치료제공삼고。방법대221례비인암환자적10항림상지표진행단인소분석화다인소COX회귀분석，근거COX회귀분석결과건립예후지수（ PI）방정，병안PI치장환자화분위엄중구강점막염고발조화저발조，비교기구강점막염발생솔적조간차이。결과다인소COX회귀분석제시동보방화료、구강호리차、채용상규방료방법시발생엄중구강점막염적고위인소， PI치＞0．2201적환자엄중구강점막염발생솔고우PI치≤0．2201환자，차이유통계학의의（ P＜0．01）。결론동보방화료、구강호리차、채용상규방료방법시발생엄중구강점막염적고위인소。 PI치능교호지예측엄중방사성구강점막염적발생，위림상진행예방화치료제공삼고。
Objective To study the high risk factors of serious oral mucositis caused by radiotherapy for the patients with nasopharyngeal carcinoma( NPC) , and to seek for the early treatment and prevention of serious oral mu-cositis, and to establish a predictive model of prognostic index( PI) for physicians to give individualized treatment. Methods The clinical factors of 221 NPC patients with oral mucositis were analyzed by univariate analysis and mul-tifactorial COX regression.PI equation was built on basis of the COX regression mode1.According to PI values, the patients were classified into 2 different risk groups.The incidence rate of serious oral mucositis was compared between the two groups.Results Multifactorial COX regression showed that chemotherapy, bad oral cavity and conventions radiotherapy were the high risk factors of serious oral mucositis.There was significant difference in the incidence rate of serious oral mucositis between the two groups classified by PI values(P<0.01).Conclusion Chemotherapy, bad oral cavity and conventions radiotherapy are high risk factors of serious oral mucositis after radiotherapy for NPC.Ear-ly treatment and preventive actions have some preventive effects on it.PI values may be useful in predicting serious o-ral mucositis caused by radiotherapy for NPC and provide the valuable information for physicians to give individualized treatment.