喉部分切除带蒂颈阔肌皮瓣喉成形术治疗喉癌的临床效果  

Clinical Effect of Partial Laryngectomy with Pedicled Platus Flap Laryngplasty for Laryngeal Carcinoma

作　　者：王虹[1] 翟红丽[1] 张子梓 WANG Hong;ZHAI Hongli;ZHANG Zizi(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2023年第1期98-100,104,共4页The Practical Journal of Cancer

摘　　要：目的 分析喉部分切除带蒂颈阔肌皮瓣喉成形术治疗喉癌的临床效果。方法 选取喉癌患者88例,按随机数字表法分为部分切除组(n=44)和全切组(n=44),全切组予以喉部全切除术,部分切除组予以喉部分切除带蒂颈阔肌皮瓣喉成形术。对比2组围术期情况、嗓音功能[振幅微扰(shimmer)、基频微扰(jitter)]、吞咽功能、并发症发生率、生存率。结果 部分切除组鼻饲管拔除时间、住院时间较全切组短,VAS评分较全切组低(P<0.05)。术后6个月,部分切除组shimmer、Jitter值较全切组低(P<0.05);部分切除组吞咽功能优于全切组(P<0.05);部分切除组并发症发生率[4.55%(2/44)]较全切组[20.45%(9/44)]低(P<0.05)。部分切除组3年生存率[94.74%(36/38)]、5年生存率[89.47%(34/38)]与全切组[80.95%(34/42)、73.81%(31/42)]对比无显著差异(P>0.05)。结论 喉部分切除带蒂颈阔肌皮瓣喉成形术治疗喉癌可促进患者喉功能恢复,缩短鼻饲管拔除时间,减轻术后疼痛,改善嗓音功能,提高吞咽能力,且并发症发生率较低,可加快患者康复进程,改善预后。Objective To analyze the clinical effect of laryngoplasty with pedicled platysma myocutaneous flap after partial laryngectomy for laryngeal cancer.Methods 88 patients with laryngeal cancer were randomly divided into 2 groups: partial laryngectomy group(n=44) and total laryngectomy group(n=44).The total laryngectomy group was treated with total laryngectomy, and the partial laryngectomy group was treated with laryngoplasty with latissimus myocutaneous flap pedicled with partial laryngectomy.Perioperative condition, voice function(amplitude perturbation, jitter),swallowing function, complication rate and survival rate were compared between the two groups.Results The nasal feeding tube removal time, hospitalization time and VAS score in partial resection group were shorter than those in total resection group(P<0.05);Six months after operation, the Shimmer and Jitter values in the partial resection group were lower than those in the total resection group(P<0.05);The swallowing function of partial resection group was better than that of total resection group(P;The complication rate of partial resection group [4.55%(2/44)] was lower than that of total resection group [20.45%(9/44)](P<0.05);The 3-year survival rate [94.74%(36/38)] and 5-year survival rate [89.47%(34/38)] in the partial resection group were not significantly different from those in the total resection group [80.95%(34/42) and 73.81%(31/42)](P>0.05).Conclusion Partial laryngectomy with pedicled platysma myocutaneous flap laryngoplasty for laryngeal cancer can promote the recovery of laryngeal function, shorten the time of nasal feeding tube removal, relieve postoperative pain, improve voice function, improve swallowing ability, and the incidence of complications is low.It can speed up the rehabilitation process of patients and improve the prognosis.

关 键 词：喉癌 喉部分切除带蒂颈阔肌皮瓣喉成形术 喉部全切除术 嗓音功能 

分 类 号：R739.65[医药卫生—肿瘤]