全厚皮片在声门型喉癌切除术中的应用  

The application of full-thicknes skin graft inpartial laryngectomy for glottic carcinoma

作　　者：付玉贵[1] 孙德重[1] 杨佩珍[1] 陈彦林[1] 陈志鹏[1] 杨兆科[1] 

机构地区：[1]临沂市人民医院耳鼻咽喉科,山东临沂276000

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第15期1226-1228,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨全厚皮片在声门型喉癌切除术中使用的经验及优点。方法:对143例声门型喉癌患者行喉部分切除术,其中78例(全厚皮片组)应用胸骨舌骨肌筋膜及游离全厚皮片修复喉腔黏膜缺损,65例(肌筋膜组)术中单纯应用胸骨舌骨肌筋膜修复,对2组术后气管套管拔管时间及喉腔肉芽生长情况进行对比。结果:全厚皮片组术后平均拔管时间6.8d;有肉芽生长5例,无肉芽生长73例;肌筋膜组术后平均拔管时间10.7d;有肉芽生长16例,无肉芽生长49例。经过统计学分析,2组患者术后拔管时间差异有统计学意义(t=-4.739,P<0.01),术后喉腔肉芽生长差异亦有统计学意义(χ2=9.379,P<0.01)。全部患者均能顺利拔管,无明显喉狭窄者。结论:在声门型喉癌患者行喉部分切除术中,应用全厚皮片能缩短拔管时间,并能显著减少喉腔肉芽的生长。Objective：The aim of this study is to explore the experience and advantages of the application of full-thicknes skin graft in glottic carcinoma, partial laryngectomy for glottic carcinoma. Method：One hundred and forty-three patients with glottic cancer were treated with partial laryngectomy. Among those, 78 cases were re- paired with fulbthickness skin graft and 65 eases were repaired with sternohyoid muscular fasciae. Compared the time of extiabation and the formation of granulation in laryngeal cavity after operation between the two groups. Re- sult ： In the group of full-thickness skin graft, the mean time of decannulation was 6.8 days, 5 cases with growth of granulation after operation. In other group, the mean time of decannulation was 10.7 days, 16 cases with growth of granulation after operation. The mean time of decannulation（t= -4. 739, P〈0.01）and the growth of granula- tion（x2= 9. 379,P〈0.01）are significantly different between the two groups. No laryngostenosis was found in all patients. Conclusion：The application of full-thicknes skin graft in partial laryngectomy for glottic carcinoma, can shortthe time of extubation and reduce the formation of granulation.

关 键 词：喉肿瘤 喉切除术 喉功能重建术 

分 类 号：R739.65[医药卫生—肿瘤]