双蒂双肌瓣在喉功能重建中应用的远期疗效观察  

Observation on the late result of double peduncle and double muscle flap in reconstruction of laryngeal function

作　　者：武乃旺[1] 刘建伟[1] 张丁香[1] 王彩凤[1] 

机构地区：[1]山西省肿瘤医院,030013

出　　处：《山西医药杂志》2000年第3期191-193,共3页Shanxi Medical Journal

摘　　要：目的　探讨双蒂双肌瓣在晚期喉癌切除、喉功能重建中的应用及远期疗效。方法　 1991— 1995年对 312例喉癌 T3、T4病变行扩大部分喉切除 ,应用单侧或双侧双蒂双肌瓣修复喉腔 ,重建喉功能。其中男 2 87例 ,女 2 5例。声门上型 2 2 6例 ,声门型 72例 ,声门下型 14例。术式包括 :扩大声门上水平部分喉切除术 ,扩大垂直部分喉切除术 , 喉切除及次全喉切除术。结果　 3年生存率 78.2 % (2 44 / 312 ) ,5年生存率 5 6 .7% (10 4/ 2 89) ,喉功能恢复情况 :总拔管率为 5 4.8% (171/ 312 )。其中扩大声门水平喉拔管率为 76 .6 % (98/ 12 8) ,扩大垂直喉拔管率为 42 .9% (40 / 93) ,次全喉切除拔管率 36 .3% (33/ 91)。吞咽功能在 7～ 10 d后恢复 ,无呛咳。发声功能良好。结论　该术式的应用 ,扩大了喉部分切除的适应证 ,提高了生存质量及生存率 。Objective In order to study the application and the late result of double peduncle and double muscle flap (DP DMF) in the resection of late stage laryngeal cancer and reconstruction of laryngeal function.Methods From 1991 to 1995 ,312 patients with T 3 and T 4 laryngeal cancer were treated by expanded partial laryngectomy and repaired with unilateral or bilateral DP DMF to reconstruct laryngeal function.In the patients,male 287,female 25,the supraglottic cancer 226,the glottic cancer 72,the subglottic cancer 14.The operation includes expanded horizontal supraglottic laryngectomy,expanded vertical partial laryngectomy,3/4 laryngectomy and subtotal laryngectomy.Results The 3 year survival rate was 78.2% (244/312),the 5 year survival rate was 56.7% (104/289). The total tracheal tube extraction rate was 54.8% (171/312), among them the rate of expanded horizontal supraglottic laryngectomy was 76.6% (98/128),the rate of expanded vertical partial laryngectomy was 42.9% (40/93), the rate of subtotal laryngectomy was 36.3% (33/91).After operation,the swallowing function returned to normal in 7 to 10 days,voiced function was good.Conclusion This method expands the indication of partial laryngectomy,improves the life quality and survival rate,with little complications.The late result is satisfactory.

关 键 词：喉肿瘤 喉切除术 喉功能重建 双蒂双肌瓣 

分 类 号：R767[医药卫生—耳鼻咽喉科]