颈部淋巴畸形患者功能状态恶化的风险因素

G. A. Polev, N. S. Grachev, R. S. Oganesyan, E. Yaremenko
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摘要

简介改善和预测头颈部淋巴畸形(尤其是颈部肿块)患者的功能状态,仍然是一个紧迫的社会经济问题。截至本文发表时,尚未有全面的科学研究探讨影响这一特殊患者群体功能状态的因果关系。阐明影响颈淋巴畸形患者功能状态的因果关系,并建立一个预测其功能衰退的模型。德米特里-罗加乔夫国立小儿血液学、肿瘤学和免疫学医学研究中心对2012年5月至2022年12月期间因颈部淋巴畸形接受治疗的115名1个月至17岁儿童和青少年患者的功能状况进行了详细分析。分析采用科隆疾病评分(CDS),根据淋巴畸形的组织学类型(微囊肿、大囊肿或混合型)和德-塞勒斯分类的分期而有所不同。研究涉及 115 名患者,中位年龄为 2.1 岁(0.4 至 5.5 岁不等)。研究结果表明,"混合淋巴畸形类型"、"de Serres 分型第五期 "和 "需要手术治疗 "是这些患者功能状态恶化的临床和统计学意义上的重要预后因素,它们分别使 CDS 评分降低了 0.976 至 4.514 分。这些研究结果支持建立该组患者功能状况恶化的预测模型。本研究制定的预测模型考虑了组织学类型、位置和治疗方式,建议在专业医疗机构中临床应用。
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Risk factors for functional state deterioration in patients with lymphatic malformation occuring in the neck region
Introduction. The improvement and prediction of functional status in patients with lymphatic malformations of the head and neck, particularly in neck masses, remains a pressing socio-economic concern. As of the publication of this article, no comprehensive scientific studies have explored the cause-and-effect relationships that impact the functional status of this specific patient demographic.Aim. To elucidate the cause-and-effect relationships impacting the functional status of patients with cervical lymphatic malformations and to develop a predictive model for their functional decline.Materials and methods. A retrospective cohort study was conducted, involving a detailed analysis of the functional status of 115 paediatric and adolescent patients aged 1 month to 17 years, treated for cervical lymphatic malformations at the Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology, and Immunology, from May 2012 to December 2022. The analysis utilised the Cologne Disease Score (CDS), varying according to the histological type of the lymphatic malformations (microcystic, macrocystic, or mixed) and the staging of the de Serres classification.Results and discussion. The study involved 115 patients with a median age of 2.1 years (ranging from 0.4 to 5.5 years). It was determined that the ‘Mixed lymphatic malformations type,’ ‘Stage V of the de Serres classification,’ and ‘Need for surgical treatment’ were clinically and statistically significant prognostic factors for the deterioration of functional status in these patients, reducing the CDS scores by 0.976 to 4.514 points, respectively. These findings supported the development of a predictive model for worsening functional status in this group.Conclusion. The predictive model formulated during this research accounts for the histological type, location, and treatment modality, and is recommended for clinical application within specialised medical institutions.
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