不同喉环状软骨上部分切除术式术后误咽发生情况分析  

Extent of post-operative deglutition disorder in patients underwent different modalities of supracricoid partial laryngectomy

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咽喉科,325000

出　　处：《浙江医学》2011年第7期974-976,981,共4页Zhejiang Medical Journal

基　　金：温州市科技局对外科技合作交流项目（H20100075）

摘　　要：目的 探讨喉环状软骨上部分切除（SCPL）的不同术式对喉癌患者术后误咽发生及其程度的可能影响.方法 2005至2009年38例喉癌患者采用喉环状软骨上部分切除-环舌骨会厌吻合术（SCPL-CHEP）,28例喉癌患者采用喉环状软骨上部分切除-环舌骨吻合术（SCPL-CHP）,对两组患者术后误咽的发生率和程度进行评估与比较,并对误咽程度与年龄之间的关系进行分析.结果 两组患者术后误咽程度的差异有统计学意义（P＜0.01）,SCPL-CHP组患者误咽程度更为明显.术后误咽程度与年龄之间呈正相关关系（P＜0.01）,年龄是两组患者术后发生误咽的一个重要因素,特别是＞70岁的高龄患者,误咽程度更为严重.术后第8周时误咽发生率SCPL-CHEP组为2.6%（1/38）,SCPL-CHP组为25.0%（7/28）,差异有统计学意义（P＜0.01）.结论 SCPL-CHEP术后出现误咽相对较少,是较安全理想的术式,而对于＞70岁的高龄喉癌患者,SCPL的这两种术式出现误咽程度均较重,尤其是SCPL-CHP术式,应特别谨慎选用.Objective To compare the extent of deglutition disorder in patients with laryngeal carcinoma underwent different modalities of supracricoid partial laryngectomy. Methods Thirty eight patients with laryngeal carcinoma underwent supracricoid partial laryngectomy with cricohyoidoepiglottopexy （SCPL-CHEP） and 28 patients underwent supracricoid partial laryngectomy-cricohyoidopexy （SCPL-CHP） from 2005 to 2009. The extent of post-operative deglutition disorder in both groups was evaluated by Ridit analysis; and its relationship with age of patients was analyzed by Pearson correlation. Results There was significant difference in the extent of deglutition disorder between the two groups （U=25.685,P 〈0.01） ; the correlation coefficient was 0.932 （P 〈0.01） in SCPL-CHEP group and 0.850 （P 〈0.01） in SCPL-CHP group respectively. There was a positive correlation between age and extent of deglutition disorder. The occurrence of deglutition disorder was 2.6%（ 1/38 ）in SCPL-CHEP group and 25%（7/28）in SCPL-CHP group 8 weeks after operation （P 〈0.01）. Conclusion SCPL-CHEP is a safe and effective operational modality for laryngeal carcinoma with less incidence of post-operational deglutition disorder. The extent of deglutition disorder in both groups increases with the age of patients, particularly for those aged over 70.

关 键 词：喉肿瘤 喉切除术 误咽 

分 类 号：R767.3[医药卫生—耳鼻咽喉科]