摘要
目的：探讨喉癌手术治疗的方法与喉功能重建疗效分析。方法：对1995～2007年收治的46例喉癌患者进行手术治疗。声门上型癌13例中Ⅰ期1例，Ⅱ期4例，Ⅲ期6例，Ⅳ期2例。声门型癌33例中Ⅰ期10例，Ⅱ期8例，Ⅲ期15例。根据不同病变情况采用相应的手术方式。结果：喉部分切除术占全部手术病例的73．9％（34／46），喉部分切除术的拔管率为76．5％（26／34），23例Ⅲ、Ⅳ期患者中喉部分切除术11例（47．8％）。全部患者恢复经口进食，喉部分切除患者均恢复发音。46例喉痛患者3年生存率为79．6％，5年生存率为70．2％。Ⅲ、Ⅳ期喉部分切除患者的3年生存率为73．5％。5年生存率为66．2％，Ⅲ、Ⅳ期全喉切除术患者的3年生存率为80．4％，5年生存率为68．6％，差异无统计学意义（P〉0．05）。结论：晚期喉癌保留喉功能是可行的，熟练掌握、择优采用各种修复方法可提高喉功能保留率。
Objective： To explore the surgical methods for larynngeal cancer and long-term effects of larygectomy. Methods： 46 cases of laryngeal cancer at different stages, including 13 cases of supraglottic cancer, 33 cases of glottic cancer, underwent operation of different kinds from 1995-2007. Postoperative radiotherapy was given to those with poorly differentiated squamous carcinoma or with metastasis of cervical lymph nodes. The effects of operation, especially that on the preservation of laryngeal function was analyzed. Results： Partial laryngectomy was performed on 34 of the 46 cases （73.90/40） and 11 of the 23 cases at stages Ⅲ and Ⅳ （47.8%）. The decannulation rate was 76.5% in the cases undergoing partial laryngectomy. The nasal feeding tube was removed and peroral feeding was recovered in all patients. All cases undergoing partial larynectomy succeeded in phonation. The overall 3-year survival rate was 79.6 % and the overall 5-year survival rate was 70.2%. For the cases with laryngeal cancer at stages Ⅲ and Ⅳ, the 3-year survival rate among those undergoing partial larygeetomy was 73.5% not significantly different from that among those cases undergoing total laryngectomy （80.4%, P〉0.05） ： the 5-year survival rate was 66.2% among those undergoing paitial laryngectomy and was 68.6% among those undergoing totals laryngectomy （P 〉0.05）. Conclusion： The rate of laryngectomy is rather high in this group. It is possible to preserve the laryngeal function without compromising the remote survival rate. The prerequisite for the preservation of laryngeal function is to master and choose the proper renovation methods.
出处
《新疆医科大学学报》
CAS
2008年第7期844-845,848,共3页
Journal of Xinjiang Medical University
关键词
喉癌
不同分型
手术治疗
laryngeal neoplasms
type
surgical management
