老年患者喉部分切除术后误咽的原因分析  

Clinical Evaluation of the Deglutition Disorder after Partial Laryngectomy in the Senile Patient with Laryngeal Carcinoma.

作　　者：林刃舆[1] 陈建福[1] 彭建华[1] 郭志强[1] 贾明辉[1] 

机构地区：[1]温州医学院附属第一医院耳鼻喉科,325000

出　　处：《医学研究杂志》2011年第6期91-94,共4页Journal of Medical Research

基　　金：温州市科技局对外科技合作交流项目(H20100075)

摘　　要：目的明确喉部分切除术式对老年喉癌患者术后误咽发生及其程度的影响。方法回顾性分析2005～2009年老年患者各种喉部分切除术后误咽的发生情况，并采用自制术后误咽程度评分表对术后5～10天患者进行误咽程度评估。结果术后误咽程度评分结果（z±s）：喉垂直部分切除术组为4．32±0．60，喉声门上水平部分切除术组为17．81±0．64，SCPL—CHEP术组为14．00±0．74，SCPL—CHP术组为18．50±0．81。喉声门上水平部分切除和SCPL—CHP术组术后误咽程度明显。术后8周评价误咽发生率：喉垂直部分切除术组为0／56，喉声门上水平部分切除术组为3／32，SCPL—CHEP术组为1／30，SCPL—CHP术组（26例）为7／26，SCPL—CHP术尤为明显。结论喉垂直部分切除术和SCPL—CHEP术是老年喉癌的较安全理想术式。对于高龄（〉75岁）喉癌患者手术方式的选择应谨慎，特别是喉声门上水平部分切除和SCPL—CHP这两种术式。Objective To evaluate the degree of the post - operative deglutition disorder between different types of partial laryngec- tomy of senile patients with laryngeal carcinoma. Methods The occurrence of postoperative deglutition disorder of 2005 - 2009 in senile patient with laryngeal carcinoma enduring different types of partial laryngectomy was analyzed retrospectively, and the exent of postopera- tive deglutition disorder in 5 - 10 days after surgery was assessed using homemade table. Results The score of deglutition disorder was 4.32 ±0.60 in the vertical partial laryngectomy group and 17.81±0.64 in the supraglottic horizontal partial laryngectomy and 14, 00±0.74 in the supracricoid partial laryngectomy - cricohyoidoepiglottopexy and 18, 50±0.81 in the supracricoid partial laryngectomy - crico- hyoidopexy. The postoperative deglutition disorder of the supraglottie horizontal partial laryngectomy and the SCPL - CHP group was obvi- ous. The incidence rate of deglutition disorder evaluated at 8 weeks post - operation was 0/56 in the vertical partial laryngectomy and 3/ 32 in the supraglottic horizontal partial laryngectomy and 1/30 in the SCPL - CHEP and 7/26 in the SCPL - CHP group respectively. In the SCPL - CHP operation group, the incidence of deglutition disorder at 8 weeks after operation was higher than others with significant difference. Conclusion The technique of vertical partial laryngectomy and supracrieoid partial laryngectomy - cricohyoidoepiglottopexy is safe and effective in senile patients with laryngeal carcinoma. For the elderly （ over 75 years of） patients, surgical method should be chosen more carefully, especially in regard to supraglottic horizontal partial laryngectomy and supracricoid partial laryngectomy - cricohyoid- opexy.

关 键 词：喉肿瘤 喉切除术 误咽 老年人 

分 类 号：R739.65[医药卫生—肿瘤]