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在尼日利亚一家热带地区的三级医疗中心管理恶性头颈肿瘤的挑战。

The challenges of managing malignant head and neck tumors in a tropical tertiary health center in Nigeria.

作者信息

Adeyi Adoga, Olugbenga Silas

机构信息

Otorhinolaryngology Unit, Department of Surgery, Jos University Teaching Hospital, PMB 2076, Jos, Plateau State, Nigeria.

出版信息

Pan Afr Med J. 2011;10:31. Epub 2011 Nov 6.

Abstract

INTRODUCTION

In developing countries, factors such as late patient presentation, inaccessible and limited health facilities contribute to the poor outcome in the management of patients with head and neck malignant tumors. This study presents the challenges faced by the otorhinolaryngologist in our environment in the management of patients with head and neck malignant tumors.

METHODS

This is a ten-year retrospective chart review of patients with histopathologically confirmed head and neck malignancies in the Jos University Teaching Hospital, Jos, Nigeria.

RESULTS

Eighty nine patients, with male predominance (gender ratio of 2.7:1) aged between 23 and 78 years had head and neck malignancies. Eighty eight (99%) patients had histopathological diagnosis. Most patients were from rural areas and had seen the herbalist prior to presentation. Thirty four (38.2%) patients were in the 4th decade of life. Eighteen (20.2%) patients presented within 6 months of onset of illness and 71 (79.8%) patients after 6 months with 38/89 patients having cervical lymphadenopathy at presentation. Four (4.5%) patients were able to afford CT scan. Twenty eight deaths were recorded. Ten patients were lost to follow-up.

CONCLUSION

The challenges faced in managing patients with head and neck malignant tumors in our environment are enormous but surmountable. Therefore urgent efforts should be made by health workers and government to ensure a better outcome for these patients.

摘要

引言

在发展中国家,诸如患者就诊延迟、医疗设施难以到达且数量有限等因素,导致头颈部恶性肿瘤患者的治疗效果不佳。本研究介绍了我们所处环境中的耳鼻喉科医生在头颈部恶性肿瘤患者管理中所面临的挑战。

方法

这是一项对尼日利亚乔斯大学教学医院经组织病理学确诊的头颈部恶性肿瘤患者进行的为期十年的回顾性病历审查。

结果

八十九名头颈部恶性肿瘤患者,以男性居多(性别比为2.7:1),年龄在23至78岁之间。八十八名(99%)患者有组织病理学诊断。大多数患者来自农村地区,在就诊前看过草药医生。三十四(38.2%)名患者处于人生的第四个十年。十八名(20.2%)患者在发病后6个月内就诊,七十一(79.8%)名患者在6个月后就诊,89名患者中有38名在就诊时伴有颈部淋巴结病。四名(4.5%)患者能够负担得起CT扫描费用。记录到28例死亡。十名患者失访。

结论

在我们所处环境中管理头颈部恶性肿瘤患者所面临的挑战巨大但可克服。因此,卫生工作者和政府应立即做出努力,以确保这些患者能有更好的治疗结果。

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