: 目的 通过生物电阻抗法(BIA),观察头颈部肿瘤放疗患者放疗期间机体液体分布,包括细胞内水分(ICW)、细胞外 水分(ECW)、身体总水分(TBW)、ECW/ ICW(%)、ECW/ TBW(%)变化,同时通过观察放疗期间口腔黏膜炎(ROM)发生时间、 程度,分析液体分布和 ROM 发生及程度的相关性。 方法 前瞻性纳入 2022 年 9 月至 2024 年 3 月在江苏省中医院放疗科行放 疗的头颈部肿瘤患者共 60 例,分别在放疗前,放疗第 2 周、4 周、6 周及放疗结束当天测定并记录 ICW、ECW、TBW、ECW/ ICW (%)、ECW/ TBW(%)液体分布指标变化。 观察放疗期间患者口腔黏膜炎发生时间及严重程度(RTOG 放射性损伤分级标 准),探讨其中的相关性。 结果 在放疗第 4 周,ICW、ECW、TBW 值随 ROM 程度而发生差异。 发生 3 级及以上的 ROM 患者与 发生 2 级及以下的 ROM 患者相比,ICW 值明显降低(P<0. 05),ECW、ECW/ ICW(%)、ECW/ TBW(%)值均增高,差异有统计学 意义(P<0. 05)。 而在其他时间段的观察中,均未发现患者机体液体分布和 ROM 发生的相关性。 结论 头颈部肿瘤患者放疗期 间机体液体分布与放射性口腔黏膜炎的发生及程度明显相关。 基于 BIA 测定的人体液体分布特点,或许可以作为放射性口腔黏 膜炎的一个潜在的预测指标,这对于筛选具有较高放射性口腔黏膜炎发生风险的患者,并在症状发生前提前干预,具有巨大的临 床意义。

Objective Bioelectrical impedance analysis BIA was used to observe the fluid distribution of patients with head and neck cancer who were undergoing radiotherapy including intracellular water extracellular water total body water ECW/ ICW % ECW/ TBW % changes. At the same time by observing the occurrence time and degree of radiation oral mucositis ROM during radiotherapy the correlation between the fluid distribution and the occurrence and degree of ROM was analyzed. Method A total of 60 patients with head and neck caner who were undergoing radiotherapy in the Radiotherapy Department of Jiangsu Province Hospital of Chinese Medicine from September 2022 to March 2024 were prospectively included. fluid distribution indicators such as ICW ECW TBW ECW/ ICW % and ECW/ TBW % were collected and recorded before at the 2nd 4th and 6th week and finished day of radiotherapy respectively. To observe the occurrence time and severity of oral mucositis during radiotherapy RTOG radiation damage grading standard and explore the correlation between them. Result The values of ICW ECW and TBW varied with the degree of ROM at the 4th week of radiotherapy. ICW values in patients with OM grade 3 or higher were significantly lower than those with OM grade 2 or lower P < 0. 05 while ECW ECW/ ICW % and ECW/ TBW % values were increased significantly P < 0. 05 . No correlations were found between fluid distribution and ROM occurrence in other time. Conclusion The fluid distribution of patients with head and neck cancer during radiotherapy was significantly related to the occurrence and degree of radiation oral mucositis. The characteristics of human fluid distribution based on BIA measurement may be used as a potential predictor of radiation-induced oral mucositis which has great clinical significance for screening patients with high risk of ROM and prior intervention before symptoms occur.