声门型喉癌保留喉功能的喉部分切除术疗效分析  

Efficacy of partial laryngectomy for glottic carcinoma

作　　者：尤乐都斯.克尤木 顾兴智[1] 阿不都.如苏力[1] 

机构地区：[1]新疆维吾尔自治区人民医院耳鼻咽喉二科,新疆乌鲁木齐830001

出　　处：《中国耳鼻咽喉头颈外科》2009年第10期547-549,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨喉部分切除术的疗效及喉功能恢复情况。方法回顾分析1997～2006年施行各种喉部分切除术声门型喉癌75例。其中男71例,女4例。其中行CO2激光声带切除术12例,喉裂开声带切除术18例,喉垂直部分切除术33例,喉额侧部分切除术5例,喉扩大垂直部分切除术4例。环状软骨舌骨会厌固定(cricohyo idoepiglottopexy,CHEP)2例。结果本组75例患者3、5年生存率分别为97.3%、94.6%。其中T1、T2病变患者48例分别为97.9%和97.9%。T3、T4病变患者(27例)分别为92.5%和85.1%。全部患者吞咽功能及发声功能均可恢复,拔管率为92.1%(58/63)。术后1个月内拔管率为85.2%。结论喉部分切除术是根治声门型喉癌的首选治疗措施。严格掌握手术适应证、选择正确术式、正确的修复技术是保证手术的疗效及保留喉功能的必要条件。OBJECTIVE To evaluate the efficacy and the recovery of laryngeal functions of various kinds of partial laryngectomy for glottic carcinoma.METHODS The clinical data of 75 patients with glottic carcinoma who underwent partial laryngectomy in our department from Jan. 1997 to Dec. 2006 were retrospectively analyzed. Seventy one cases were male and 4 cases were female. There were 6 kinds of surgical methods for those patients. CO2 laser assisted vocal cordectomy was operated on in 12 cases, vocal cordectomy through laryngofissure in 18 cases, vertical partial laryngectomy in 33 cases, frontal partial laryngectomy in 5 cases, extended vertical partial laryngectomy in 4 cases, and CHEP in 2 cases. RESULTS The overall 3 and 5 year survival rates of the patients were 97.3% and 94.6% respectively. The 3 and 5 year survival rates in 48 cases with stage T1/T2 were 97.9% and 97.9% and those in 27 cases with stage T3/T4 were 92.5% and 85.1%. All of the patients restored the phonation and swallowing function. The decannulation rate was 92.1% （58/63） . The decannulation rate of the patients within one month after operation was 85.2% CONCLUSION Partial laryngectomy is the first choice of the radical treatments for glottic carcinoma. Strict indications, correct procedure and surgical repair methods are the keys to ensure the efficacy and preservation of laryngeal function.

关 键 词：喉肿瘤 喉切除术 修复外科手术 存活率 

分 类 号：R739.65[医药卫生—肿瘤] R739.63[医药卫生—临床医学]