摘要
目的 :探讨T1、T2 期声门型喉癌的治疗方法。方法 :对 112例T1、T2 期声门型喉癌 (T1N0 M0 、T2 N0 M0 )患者施行喉小部分切除术。对手术方法、术后功能的恢复、治疗效果及治疗优势进行了总结 ,并与激光、放疗作了对比 ;对术后披裂的活动、声门裂的形态及嗓音变化作了动态观察随访 ;应用Dr.speech嗓音质量评估软件对术前、术后嗓音质量做了分析对比。结果 :112例患者切口均Ⅰ期愈合 ,6～ 7d拆线 ,平均住院时间 9.76d。术后 2～ 3d恢复经口进食。住院期间顺利拔除气管套管 ,平均戴管时间 7.32d,拔管率 10 0 %。术后 1周 4 7例出现披裂活动减弱 ,但逐步改善 ,2个月后声门裂形态接近正常 ;术前与术后 2个月、6个月Shimmer和NNE对比 ,差异有统计学意义 (P <0 .0 1) ,术后 1周与术后 2个月、6个月比较差异有统计学意义 (P <0 .0 1)。随访满 3年76例 ,全部生存 ;满 5年 36例 ,35例生存 (1例不明原因死亡 ) ;复发 2例。结论 :喉小部分切除术视野清楚 ,病变切除彻底 ,短期内顺利恢复了饮食及语言功能 ,并提高了发声质量 ,治疗T1、T2 期声门型喉癌是可行的。
Objective:To explore the surgery way for T 1、T 2 glottic carcinoma.Method:Small partial laryngectomy were performed to 112 patients with T 1、T 2(T 1N 0M 0,T 2N 0M 0) glottic carcinoma. The surgery method, effect and treatment advantage was summarized and compared with laser therapy and radiotherapy, the dynamic follow up of arytaenoidea cartilage movement, glottidis rimae conformation and voice change was analyzed. The preoperative and postoperative voice quality was compared with the software of Dr. speech system for windows.Result:All incisions were healed one stage in 6 or 7 days, the mean time in hospital is 9.76 days; all patients took food with mouth after 2 or 3 days, all trachea cannula was removed successfully during in hospital, the mean time with cannula is 7.32 days and the rate of removing cannula 100%. Arytaenoidea cartilago movement of 47 cases 1 week after surgery weakened and gradually improved, glottidis rimae conformation is close to be normal after 2 months.There is no significant difference of Shimmer and NNE between preoperative and postoperative 1 week(P> 0.05 ), but there is a significant difference between preoperative and postoperative 2 months,half a year, and also is between postoperative 1 week and 2 months,half a year(P< 0.01 ).All 76 cases survive during 3 years' follow up, 35 of 36 cases in 5 years' follow up survive (1 case died without definite cause), and there is 2 cases for recurrence.Conclusion:Small partial laryngectomy can provide large operative view, resect the tumor completely,make diet and speech recover in shorter time and improve the voice quality, so the surgery is available.
出处
《临床耳鼻咽喉科杂志》
CSCD
北大核心
2004年第6期350-352,共3页
Journal of Clinical Otorhinolaryngology
关键词
喉肿瘤
喉切除术
喉功能重建
嗓音声学分析
Laryngeal neoplasms
Laryngectomy
Reconstruction of larynx
Voice acoustic analysis
