ABSTRACT
Objective To explore the incidence of dysphagia and its potential risk factors.Methods From January 2014 to December 2015,a total of 187 patients who underwent single-level anterior cervical spine surgery were recruited in this retrospective analysis study.Specific perioperative data including age,gender,smoking,alcohol use,BMI,estimated blood loss,surgical segment,length of incision,and length of hospital stay were recorded respectively.The Bazaz grading system and the swallowing quality of life (SWAL-QOL) score were used to assess the presence and severity of dysphagia.According to the Bazaz grading system,the patients were divided into dysphagia group and non-dysphagia group 1 week after operation.One-factor x2 test and one-sample t test were used to univariate analyze the two groups of related factors,and select the potential variables for multivariate logistic regression analysis to identify the risk factors leading to dysphagia.Results The number of dysphagia patient was 99 (52.94％) at 1 week after surgery,and 16 (8.56％) at 1 year.The preoperative mean SWAL-QOL score was 65.62±4.41 points,which decreased to 58.72±7.54 points after surgery and rose up to 64.66±5.26 points at the 12-month follow-up.The SWAL-QOL score at 1 week after surgery was correlated with the operative time (r=-0.474;P ＜ 0.001).Multivariate analysis indicated that preoperative tracheal exercise (OR=0.302,95％CI:0.131,0.748),operation time ＜ 60 min (OR=0.407,95％CI:0.190,0.878),and arthroplasty (OR=0.211,95％CI:0.102,0.425) were the independent factors to reduce the incidence of postoperative dysphagia.Conclusion The incidence and severity of dysphagia symptoms after single-level anterior cervical spine surgery gradually decreased with the extension of follow-up time.Preoperative tracheal exercise,shortened operative time and manual artificial disc replacement may be helpful to reduce the postoperative occurrence of dysphagia.
ABSTRACT
Objective:To evaluate the clinical value of percutaneous microwave coagulation therapy for peripheral non-small-cell lung cancer. Methods:We evaluated 35 patients with non-small-cell lung cancer who received percutaneous microwave coagulation therapy and 35 patients who received radiotherapy from March 2004 to September 2006;the patients were sex-matched, age-matched, and had the same pathology and clinical staging. Clinical effects were observed and assessed. Survival rate were calculated using the Kaplan-Meier method. The difference in survival rate between the two treatment methods was analyzed using a log-rank test. Results:The 1-year, 3-year, and 5-year survival rates for the microwave coagulation therapy group (71.4%, 40.0%, and 20.0%, respectively) were significantly higher than those for the radiation therapy (51.4%, 22.9%, and 11.4%, respectively) (P<0.05). Conclusion:Percutaneous microwave coagulation therapy is a minimally invasive, safe, and effective alternative for patients with peripheral non-small-cell lung cancer who cannot undergo routine surgery because of poor heart and lung function or fear of surgical trauma.