两种修复方式在喉部分切除术后喉功能重建中的应用价值  

Application of two methods to reconstruction of laryngeal function after partial laryngectomy for laryngeal carcinoma

作　　者：冯华君[1] 陈嘉[1] 赵飞鹏[1] 许胜恩[1] 徐伟[1] 孙晓强[1] 覃纲[1] 

机构地区：[1]泸州医学院附属医院耳鼻咽喉头颈外科,四川泸州646000

出　　处：《中国现代医学杂志》2016年第1期132-136,共5页China Journal of Modern Medicine

摘　　要：目的探讨接力肌甲状软骨外软骨膜瓣和室带下移两种修复方式在喉癌喉部分切除术后喉功能重建中的治疗效果和应用价值。方法对泸州医学院附属医院耳鼻咽喉头颈外科2011年12月-2014年2月经病理确诊为喉癌、初次行喉部分切除术并采用接力肌甲状软骨外软骨膜瓣或（和）室带下移进行喉功能重建术的40例喉癌患者进行随访、病历资料分析。结果 40例患者无1例失访。术后全部患者6～16 d恢复经口进食,无呛咳及误吸。拔除气管套管39例,拔管率为97.5%（39/40）。除1例患者术后电子喉镜提示喉腔狭窄外,其余患者喉腔均宽敞。所有患者均能利用新喉发音,无1例因喉腔闭锁导致发音失败。结论接力肌甲状软骨外软骨膜瓣和室带下移这两种喉功能修复方法单独或联合应用均能很好的重建喉腔形态,保留喉的生理功能,是喉癌喉部分切除术后喉功能重建的简便、有效方式。Objective To discuss the treatment effect and application value of the ventricular bands and the myoperichondral flap in reconstruction of laryngeal function after partial laryngectomy for laryngeal carcinoma. Methods The clinical data of 40 cases with laryngeal cancer were retrospectively reviewed. They were treated by reconstruction of laryngeal function with the ventricular bands and the myoperichondral flap after partial laryngectomy in the Department of Otolaryngology, Head and Neck Surgery, the Affiliated Hospital of Luzhou Medical College from Dec. 2011 to Feb. 2014. Results All the cases were followed up. All the cases began to take food through mouth 6-16 days after operation without deglutition disorder, no aspiration or choking accident occurred. The decannulation rate was 97.5%（39/40）. The laryngeal cavities of the patients were spacious except 1 case via electronic laryngoscope examination after operation. All the cases were able to speak by the new larynx, no one failed for laryngotracheal atresia. Conclusions The laryngeal function reconstruction after partial laryngectomy with the ventricular bands moving down and/or the myoperichondral flap would be able to well rebuild the shape of the laryngeal cavity and keep well the physiological function of larynx. These two methods are simple and effective for laryngeal functional reconstruction after partial laryngectomy.

关 键 词：喉肿瘤 喉切除术 喉功能重建 室带 外科皮瓣 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]