鼻咽癌放疗后放射性脑病相关顽固性吸入性肺炎手术治疗方式的探讨  

Study of laryngotracheal separation for post-radiotherapy nasopharyngeal cancer patients who had radiation encephalopathy which caused intractable aspiration pneumonia

作　　者：雷文斌[1] 苏振忠[1] 蒋爱云[1] 柴丽萍[1] 文卫平[1] 祝小林[1] 贾涛[1] 

机构地区：[1]中山大学附属第一医院耳鼻咽喉科医院,耳鼻咽喉科学研究所,广州510080

出　　处：《中国实用医药》2007年第25期4-6,共3页China Practical Medicine

基　　金：广东省科技计划项目(项目编号:2006B60501022)

摘　　要：目的探索用手术方法解除鼻咽癌放疗后放射性脑病相关顽固性吸入性肺炎,提高患者的生存质量和延长生存期。方法用两种术式分别处理2例典型患者,将喉气管分离,堵截食物误入气道的途径,并以颈前气管造口代替佩戴气管套管。结果2例典型患者在手术治疗后,分别随访观察2年和4年,肺部感染在手术后2周治愈,未再次出现吸入性肺部感染,1例恢复部分户外活动,另1例恢复经口进食,2例体质量增加5kg以上,生活质量和心理状态均有明显改善。结论喉-气管分离术能有效防治鼻咽癌放疗后放射性脑病相关顽固性吸入性肺炎,值得临床推广。Objective To investigate the method for post-radiotherapy nasopharyngeal cancer patients who suffered from radiation encephalopathy which caused intractable aspiration pneumonia,improve their quality of life and extend their life.Methods 2 typical cases of post-radiotherapy nasopharyngeal cancer patients who suffered from pseudobulbar palsy were underwent 2 kinds of laryngotracheal separation operations respectively.The way of food entered the airway were blocked.Tracheal cannula were removes and substituted by tracheostoma.Results 2 cases were followed up more than 2 years after operation.Aspiration pneumonia was cured 2 weeks after operation,and wasn’t complained any more.One case was able to have some outdoor living after operation,another could take food by mouth.Both gained weight more than 5 kg.Quality of life and mental state were improved obviously.Conclusion Laryngotracheal separation was effective for post-radiotherapy nasopharyngeal cancer patients who had pseudobulbar palsy which caused intractable aspiration pneumonia,and was worth spreading in clinic.

关 键 词：鼻咽癌 放射性脑病 喉-气管分离术 

分 类 号：R739.6[医药卫生—肿瘤]