结合内镜的甲状软骨开窗式喉部分切除术临床效果初步报告  

Window partial laryngectomy with endoscopy for the treatment of stage T_(1b)-T_3 laryngeal carcinoma

作　　者：舒畅[1] 彭志林[1] 陈建超[1] 孙常领[1] 殷潇[1] 

机构地区：[1]无锡市第四人民医院(苏州大学附属第四医学院)耳鼻咽喉头颈外科,江苏无锡214062

出　　处：《临床耳鼻咽喉头颈外科杂志》2010年第8期362-364,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨结合内镜技术甲状软骨开窗式喉部分切除术治疗部分T1b～T3声门型喉癌的手术效果。方法:采用结合内镜的甲状软骨开窗式喉部分切除术并一期喉功能重建治疗27例T1b～T3声门型喉癌患者,并对术后3、5年生存率及喉功能(呼吸功能、发声功能、吞咽保护功能)恢复进行评价。结果:术后3年生存率为83.3%(15/18),5年生存率为75.0%(9/12)。术后4周拔管率为92.6%(25/27)。术后3个月呼吸功能评价:拔管后3个月Ⅰ级77.8%(21/27),Ⅱ级14.8%(4/27),Ⅲ级7.4%(2/27)。术后4周全部患者恢复吞咽功能无呛咳。发声功能评估:术后3个月Ⅱ级74.1%(20/27),Ⅲ级25.9%(7/27)。术后喉腔局部复发率:3年为10.5%(2/19),5年为15.4%(2/13)。结论:结合内镜技术甲状软骨开窗式喉部分切除术术后复发率及死亡率均较低;术后呼吸、发声、吞咽功能恢复较为满意。适用于T1b、T2及部分T3喉癌。Objective：To investigate the operative effect and value of window partial laryngetomy with endoscopy for treatment of stage T1b-T3 laryngeal cancer.Method：Twenty-seven cases with glottic laryngeal cancer were treated by window partial laryngectomy with endoscopy.After 3-year and 5-year survival rate and laryngeal functions（respiratory,pronunciation,swallowing function）recovery were evaluated.Result：The 3-and 5-year survival rates were 83.3%（15/18） and 75.0%（9/12） respectively.The decannulation rate was 92.6%（25/27）4 weeks after operation.Three months after decannulation of respiratory function evaluation： the march to fast runner 77.8%（21/27）,the jogger 14.8（4/27）,who walk briskly 7.4%（2/27）.All patients had recovered after four weeks swallowing without choking cough and satisfied with phonation.Local recurrence rates at 3 and 5 year after operation were 10.5%（2/19） and 15.4%（2/13） respectively.Conclusion：The reserch shows that window partial laryngectomy with endoscopy was applicable to stage T1b-T2 and selacting T3 laryngeal cancer patiants.Postoperative respiratory,pronunciation and swallowing function recovery rate is satisfactory.

关 键 词：喉肿瘤 喉切除术 内镜 

分 类 号：R739.65[医药卫生—肿瘤]