非功能损伤手术治疗下咽癌的疗效研究  

The effect of function-preserving surgery in the treatment of hypopharyngeal cancer

作　　者：曾巍[1] 梁冀望[1] 樊欣龙 

机构地区：[1]辽宁省肿瘤医院头颈外科,辽宁沈阳1100420

出　　处：《癌症进展》2016年第10期1016-1018,共3页Oncology Progress

摘　　要：目的探讨非功能损伤手术对下咽癌的治疗效果。方法选取100例下咽癌患者为观察对象,根据其手术方式不同分为保留喉功能组35例和未保留喉功能组65例。观察两组患者术后恢复情况、生存率、并发症发生率和生活质量的差异。结果保留喉功能组患者的手术时间较未保留喉功能组长(P﹤0.01),而两组患者术中出血量和住院时间差异无统计学意义(P﹥0.05);保留喉功能组患者吞咽、语言和呼吸恢复率高于未保留喉功能组(P﹤0.05);保留喉功能组咽瘘、皮瓣坏死发生率明显低于未保留喉功能组(P﹤0.05),而两组患者术后感染发生率无统计学意义(P﹥0.05);保留喉功能组患者1年和3年生存率明显高于未保留喉功能组(P﹤0.05);两组患者手术前生活质量得分比较差异无统计学意义;术后两组患者的生活质量均较手术前降低,且未保留喉功能组降低更明显(P﹤0.05)。结论非功能损伤性手术对下咽癌有较好的治疗效果,可明显促进患者术后吞咽、语言和呼吸功能的恢复,提高患者术后生活质量。Objective To investigate the effect of function-preserving surgery in the treatment of hypopharyngeal cancer. Method 100 cases of hypopharyngeal carcinoma were enrolled in the study and stratified as function-preserving group （n=35） or non-function-preserving group （n=65） as per respective surgery given. The postoperative recovery of the two groups were observed, and the survival rate, incidence of postoperative complications and the quality of life of the two groups were compared. Result The operative time of the patients in function-preserving group was longer than that in non-function-preserving group （P〈0.01）, but there was no significant difference between the two groups in regard of in-traoperative blood loss and hospital stay （P〉0.05）;Higher recovery rates of swallowing, language and respiratory func-tions were observed in function-preserving group, with significant difference observed （P〈0.05）; Function-preserving group had lower incidences of pharyngeal fistula and skin flap necrosis than that in non-function-preserving group （P〈0.05）, while the postoperative infection rate was similar （P〉0.05）;The 1-and 3-year survival rate was significantly high-er in function-preserving group than that of non-function-preserving group, the difference was statistically significant;Af-ter surgery, the quality of life of all patients’was lower than before, and more significant decrease was observed in the non-function-preserving group （P〈0.05）. Conclusion Function-preserving surgery is therapeutically effective in the treatment of hypopharyngeal carcinoma, promoting the recovery of swallowing, language and respiratory function, and improving the quality of life of patients after surgery.

关 键 词：功能损伤 下咽癌 喉功能 生活质量 

分 类 号：R739.6[医药卫生—肿瘤]