两种不同保留喉功能治疗方式对晚期下咽癌的疗效及生活质量影响  

The effect of two different laryngeal function preserving therapies on the curative effect and quality of life in patients with advanced hypopharyngeal cancer

作　　者：李家容[1] 戚思国 李聪 胡芳[2] LI Jiarong;QI Siguo;LI Cong;HU Fang(Department of Otorhinolaryngology Head and Neck Surgery,Dazhou Central Hospital,Dazhou,Sichuan,635000,China)

机构地区：[1]四川达州市中心医院耳鼻咽喉头颈外科,635000 [2]四川达州市中心医院肿瘤科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2022年第2期121-126,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨两种不同保留喉功能治疗方式对局部晚期下咽癌患者的疗效及生活质量的影响。方法回顾性研究2014年1月~2019年1月在我院收治的118例局部晚期下咽癌患者的临床资料。依据治疗方案将所有患者分为保留手术组和同步放化疗组,各59例,保留手术组予以病灶切除及喉功能保留手术治疗,同步放化疗组予以靶区直线加速器适型调强放射治疗和化疗,对两组患者的临床疗效、术后并发症和生活质量情况进行比较和评估。结果经干预治疗后,保留喉功能手术组临床有效率显著高于同步放化疗组,差异具有统计学意义(P<0.05);保留手术组躯体功能、躯体职能、躯体疼痛、活力、社会功能、情感职能、精神健康和总体健康等生存质量评分均显著高于同步放化疗组(P<0.05)。两组患者在咽瘘方面无显著差异(P>0.05)。保留手术组皮瓣坏死显著高于同步放化疗组,但吞咽困难、语言障碍和呼吸障碍者显著低于同步放化疗组(P<0.05)。此外,保留喉功能手术组3年局部复发率明显低于同步放化疗组(P<0.05)。结论在喉功能保留的治疗方式中,采用喉功能保留手术,可显著改善下咽癌患者术后吞咽、语言和呼吸功能的恢复,提高患者术后生活质量,有较好的治疗效果。Objective To explore the effects of two different treatments to preserve laryngeal function on the efficacy and quality of life of patients with locally advanced hypopharyngeal carcinoma.Methods The clinical data of 118 patients with locally advanced hypopharyngeal cancer from January 2014 to January 2019 were retrospectively studied.According to the treatment plan,all patients were divided into the function-preserving surgery group and the concurrent radiotherapy and chemotherapy group,with 59 cases for each group.The function-preserving surgery group was treated with focus resection and laryngeal function preservation operation.The concurrent radiotherapy and chemotherapy group was treated with linear accelerator intensity-modulated radiotherapy and chemotherapy.The curative effect,postoperative complications and quality of life of both groups were evaluated.Results After the treatment,the curative effective rate of the function-preserving surgery group was significantly higher than that of the concurrent radiotherapy and chemotherapy group(P<0.05).The scores of physical function,physical pain,vitality,social function,emotional function,mental health and overall health of the function-preserving surgery group were significantly higher than those of the concurrent radiotherapy and chemotherapy group(P<0.05).There was no significant difference in pharyngeal fistula between the two groups(P>0.05).The skin flap necrosis in the laryngeal function-preserving surgery group was significantly higher than that in the concurrent radiotherapy and chemotherapy group,but the patients with dysphagia,speech disorder and breathing disorder were significantly lower than those in the concurrent chemoradiation group(P<0.05).The 3-year local recurrence rate in the laryngeal function preserving surgery group was significantly lower than the concurrent radiotherapy and chemotherapy group(P>0.05).Conclusions In the treatment of laryngeal function preservation,the laryngeal function preservation surgery can significantly improve the re

关 键 词：下咽癌 手术 喉功能 生活质量 临床疗效 

分 类 号：R739.63[医药卫生—肿瘤]