不同术式治疗喉癌患者的疗效分析  

Efficacy investigation of different operative methods in patients with laryngeal cancer

作　　者：刘根久 李随勤[2] 

机构地区：[1]陕西省富平县医院耳鼻喉科,富平711700 [2]西安交通大学第一附属医院耳鼻咽喉头颈外科,西安710061

出　　处：《中国肿瘤临床与康复》2016年第4期446-448,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨不同术式对喉癌患者的喉部功能、生存时间和生活质量的影响。方法选取2010年1月至2014年3月间收治的80例喉癌患者,其中全喉切除术19例,水平半喉切除术21例,垂直半喉切除术22例,喉裂手术18例。对所有患者进行门诊复诊或电话随访,Kaplan-Meier法计算生存率。结果全喉切除术患者拔管率为84.2%,水平半喉切除患者拔管率为90.5%,垂直半喉切除率患者拔管率为90.9%,喉裂手术患者拔管率为88.9%。随访结果显示,部分患者出现喉癌复发、颈部转移、肝转移、脑转移和食管转移。3年生存率为90.0%,其中肿瘤转移和喉癌复发是死亡的主要原因。结论喉癌的治疗以手术为主,根据肿瘤分期、发病部位、年龄等多种因素,实施个性化手术治疗方案。在保证肿瘤彻底切除的前提下,主张功能性手术和微创手术。同时在有需要的情况下,行颈淋巴结清扫可以减少肿瘤复发和转移的概率,尽可能提高患者生存率及术后生活质量。Objective To investigate the efficacy of different operative methods patients with laryngeal cancer. Methods From January 2010 to March 2014,80 laryngeal cancer patients with operative treatment were enrolled in the study and the related data were analyzed. 19 cases accepted total laryngectomy,21 cases horizontal laryngectomy,22 cases vertical hemilaryngectomy and 18 cases laryngeal cleft surgery. The patients were with outpatient follow-up visit or telephone followed-up and the survival rate was calculated by Kaplan-Meier. Results The decannulation rate of total laryngectomy was 84. 2%; the horizontal laryngectomy was 90. 5%; the vertical hemilaryngectomy was 90. 9%; the laryngeal cleft surgery was88. 9%. After followed-up,recurrent laryngeal,neck metastasis,liver metastasis,brain metastases and esophagus occurred. The 3-yr survival rate was 90. 0% and cancer metastasis and recurrence of laryngeal cancer were main causes of death. Conclusions The main treatment of laryngeal cancer is surgery,and the multi-factors are cancer stage,location and age,which should given personalized surgical treatment.Under the premise of guarantee of radical tumor resection,the patients should be given functional surgery and minimally invasive surgery.

关 键 词：喉肿瘤 咽切除术 生存率 

分 类 号：R739.65[医药卫生—肿瘤]