64例下咽癌病人临床疗效的回顾分析  

Clinical analysis of the curative effects in 64 patients with hypopharyngeal carcinoma

作　　者：刘洪英[1] 魏丽萍[1] 许朝霞[1] 张春丽[1] 

机构地区：[1]山东济南铁路中心医院耳鼻咽喉科,250001

出　　处：《耳鼻咽喉（头颈外科）》2001年第2期92-94,共3页Chinese Arch Otolaryngology-Head Neck Surg

摘　　要：目的 :探讨下咽癌外科切除与修复手术的治疗效果。方法 :分析 1989年 1月～ 1995年 9月 6 4例下咽癌切除患者的手术方法、并发症、生存率等 ,其中保留喉功能的下咽癌切除患者 2 6例 ,未保留喉功能的下咽癌切除患者 38例。结果 :6 4例下咽癌患者手术后全部恢复了吞咽功能 ,并发症发生率 40 .6 % (2 6 / 6 4) ,以咽瘘最常见。2 6例保留喉功能的下咽癌切除术后拔管率 5 3.8% (14/ 2 6 ) ,3年和 5年生存率分别为 6 5 .4% (17/ 2 6 )和 5 0 % (13/ 2 6 )。38例喉全切除下咽癌患者 3年和 5年生存率分别为 5 2 .6 % (2 0 / 38)和 44 .7% (17/ 38)。保留喉功能和未保留喉功能两者 3、5年生存率比较没有显著差异 (P >0 .0 5 )。结论 :保留喉功能下咽癌手术适用于 T1 、T2 期的肿瘤及经过仔细选择部分 T3期肿瘤患者 ,不影响患者的长期生存率 。Objective:To study the curative effects of hypopharyngeal carcinoma by treatment of pharyngectomy and repairment surgery Methods:Sixty four patients with hypopharyngeal squamous cell carcinoma were treated by pharyngectomy and repaired the defect of pharynx from 1989 to 1995 There were 58 males and 6 females,ranging in age from 37 to 73 years old There were stages T 1 in 3(T 1N 0M 0 1,T 1N 2M 0 2),T 2 in 12(T 2N 0M 0 4,T 2N 1M 0 5,T 2N 2M 0 2,T 2N 3M 0 1),T 3 in 29(T 3N 0M 0 7, T 3N 1M 0 14,T 3N 2M 0 6,T 3N 3M 0 2),and T 4 in 20 (T 4N 0M 0 2, T 4N 1M 0 3,T 4N 2M 0 8,T 4N 3M 0 7) Among 64 patients,26 cases were treated by surgery of laryngeal function preservation (group A,stages T 1,2,3 ),38 cases did not laryngeal function preservation (group B,stage T 4) Results:The swallow function was returned to normal in all 64 patients after treatments,and the complications were 26/64(40 6%)most of those was pharyngeal fistula The rate of decannulation was 53 8%(14/26) in the group A,and the 3 year and 5 year survival rate were 65.4% (17/26) and 50 0% (13/26) respectively. In the group B, the 3\|year and 5\|year surviral rates were 52 6%(29/38)and 44 7%(17/38)respectively There were no significant differences in the 3 or 5 year survival rate between two groups (P>0 05) Conclusion:The indications of those procedure of laryngeal function preservation were stages T 1,2,3 of patients with hypopharyngeal carcinoma,which were no affection on the 3 or 5 year survival rates,and the survival quality of patients were improved

关 键 词：咽肿瘤 癌 外科手术 治疗 

分 类 号：R739.63[医药卫生—肿瘤]