双侧声带切除并龙骨植入术与环会厌吻合术治疗双声带癌的效果比较  

Comparison of the Effect on Bilateral Vocal Cord Resection with Keel Implantation and Circumnegative Anastomosis in the Treatment of Dual Vocal Cord Cancer

作　　者：李俊丽 王亮[1] LI Jun-li;WANG Liang(Department of Otolaryngology-Head and Neck Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院耳鼻咽喉头颈外科,河南郑州450052

出　　处：《河南医学研究》2020年第15期2734-2737,共4页Henan Medical Research

摘　　要：目的比较双侧声带切除并龙骨植入术与环会厌吻合术治疗双侧声带癌患者的临床效果。方法选取侵犯双侧声带及前联合的86例声门型喉癌患者,行双侧声带切除并龙骨植入术的48例患者为A组,行环会厌吻合术的38例患者为B组。随访3 a,对两组患者的生存率、局部复发率、堵管时间、拔管时间、拔管率及鼻饲时间进行比较。结果 A组患者3年生存率(93.75%)与B组(97.37%)比较,差异无统计学意义(P>0.05);A组患者局部复发率(18.75%)高于B组(2.70%),差异有统计学意义(P<0.05);A组堵管时间[10.00(8.00,11.00)d]短于B组[13.00(12.00,14.00)d],差异有统计学意义(P<0.05);A组拔管时间[36.00(33.25,40.00)d]长于B组[29.50(27.00,34.50)d],差异有统计学意义(P<0.05);A组拔管率(79.16%)低于B组(97.37%),差异有统计学意义(P<0.05);A组鼻饲时间[10.00(8.00,11.00)d]短于B组[11.00(10.00,12.00)d],差异有统计学意义(P<0.05)。结论双侧声带切除并龙骨植入术较环会厌吻合术可缩短患者堵管时间,减少留置胃管的时间,但环会厌吻合术具有局部复发率较低、拔管率高的优点,在临床中推荐使用环会厌吻合术。Objective To compare the clinical effect on bilateral vocal cord resection combined with keel implantation and circumnegative anastomosis in the treatment of dual vocal cord cancer.Methods The total of 86 patients with glottic carcinoma invading bilateral vocal cord and anterior union were selected. Forty-eight patients(group A) underwent bilateral vocal cord resection with keel implantation and 38 patients(group B) underwent annular epiglottic anastomosis. Followed up for 3 years, the survival rate, local recurrence rate, blockage time, extubation time, extubation rate and nasal feeding time were compared.Results There was no significant difference in the three-year survival rate between the group A(93.75%) and the group B(97.37%)(P>0.05). The local recurrence rate of group A(18.75%) was higher than that of group B(2.70%), and the difference was statistically significant(P<0.05). The blocked time in group A [10.00(8.00, 11.00) days] was shorter than group B [13.00(12.00, 14.00) days], and the difference was statistically significant(P<0.05). Time days in group A [36.00(33.25, 40.00)] was longer than group B [29.50(27.00, 34.50) days], and the difference was statistically significant(P<0.05). The extubation rate of group A(79.16%) was lower than group B(97.37%), and the difference was statistically significant(P<0.05). The nasal feeding time in group A [10.00(8.00, 11.00) days] was shorter than group B [11.00(10.00, 12.00) days], and the difference was statistically significant(P<0.05).Conclusion Compared with circumnegative anastomosis, bilateral vocal cord resection and keel implantation can shorten the time of tube obstruction and indwelling gastric tube. Circumnegative anastomosis has the advantages of lower local recurrence rate and high extubation rate. Therefore, circumnegative anastomosis is recommended in clinical practice.

关 键 词：双侧声带癌 龙骨植入术 环会厌吻合术 

分 类 号：R739.6[医药卫生—肿瘤]