声门上型喉癌切除术同期行择区性颈清扫术的有效性评价  

Evaluation of efficacy of supraglottic laryngeal carcinoma resection together with selective neck dissection

作　　者：庐健 

机构地区：[1]解放军第一七一医院耳鼻咽喉科,江西九江332000

出　　处：《中国现代医生》2015年第33期70-72,76,共4页China Modern Doctor

摘　　要：目的评价声门上型喉癌切除术同期行择区性颈部清除术的有效性。方法收集我院耳鼻喉科2008年3月-2010年1月收治的32例声门上型癌患者,患者均行声门上喉切除术,且患者根据基本情况选择不同的颈部淋巴结清扫术,随访观察患者疾病恢复情况,分析3年、5年生存率。结果不同颈部淋巴结清扫方式患者3年生存率、5年生存率差异均具有统计学意义（P〈0.05）,且N0改良全颈清扫术、N＋经典全颈部清扫术与N0未行任何颈部清扫术生存率差异具有统计学意义（P〈0.05）,N0改良全颈清扫术与N＋经典全颈清扫术间比较差异无统计学意义（P〉0.05）。四期3年生存率、5年生存率间差异均具有统计学意义（P〈0.05）;Ⅰ、Ⅱ期3年生存率、5年生存率分别为80.0%、30.0%、Ⅲ、Ⅳ期为72.7%、27.3%,差异具有统计学意义（χ^2=4.562、5.782、P=0.032、0.025）。患者发生死亡原因主要有复发、远处转移、心血管疾病以及其他严重疾病,患者复发率15.3%、远处转移15.3%,心血管疾病3.1%,其他疾病为9.4%,因此引起术后死亡主要原因为复发和远处转移。结论声门上型喉癌切除术同期行择区性颈清扫术可以明显提高患者的3年、5年生存率。Objective To evaluate the efficacy of resection of supraglottic laryngeal carcinoma together with selective neck dissection.Methods A total of 32 patients with supraglottic laryngeal carcinoma who were admitted to the Department of Otorhinolaryngology in our hospital from March 2008 to January 2010 were collected.Supraglottic laryngectomy was applied in all the 32 cases.Different neck lymph dissection was adopted according to the conditions of the patients.Follow-ups were established to observe the recovery and 3-year and 5-year survival rate were analyzed.Results The differences of 3-year and 5-year survival rate of patients receiving different type of neck lymph dissection were statistically significant（P〈0.05）,and the differences of N0 improved neck lymph dissection,N＋ classical neck lymph dissection and N0 non neck lymph dissection were statistically significant（P〈0.05）,while the differences between N0 improved neck lymph dissection and N＋ classical neck lymph dissection were not statistically significant（P〉0.05）.The differences between 3-year and 5-year survival rate of phase Ⅳ were statistically significant（P〈0.05）.The 3-year and5-year survival rate of phase Ⅰ and Ⅱ were 80.0%and 30.0%and the rate of phase Ⅲ and Ⅳ were 72.7%and27.3%,which showed a statistically significant differences（χ^2=4.562,5.782,P=0.032,0.025）.Causes for postoperative death were recurrence,distant metastasis,cardiovascular disease and other severe diseases with the 15.3%,15.5%,3.1%and 9.4%respectively.Therefore,recurrence and distant metastasis were the primary causes for death after the operation.Conclusion Resection of supraglottic laryngeal carcinoma together with selective neck dissection is able to significantly increase the 3-year and 5-year survival rate.

关 键 词：声门上型喉癌切除术 择区性颈清扫术 生存率 有效性 

分 类 号：R739.6[医药卫生—肿瘤]