环状软骨上部分喉切除术治疗喉鳞状细胞癌的效果及对患者嗓音功能及吞咽功能的影响  

Therapeutic effect of cricohyoidoepiglottopexy on laryngeal squamous cell carcinoma and its influence on vocal and swallowing function

作　　者：高长辉[1] 尚伟 Gao Changhui;Shang Wei(Department of Throat and Head and Neck Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院咽喉头颈外科,郑州450000

出　　处：《中国实用医刊》2024年第16期1-4,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨环状软骨上部分喉切除术(CHEP)治疗喉鳞状细胞癌的效果及对患者嗓音功能及吞咽功能的影响。方法队列研究。抽取2021年1月至2023年10月郑州大学第一附属医院收治的喉鳞状细胞癌患者82例,按随机数字表法分为对照组和观察组,每组41例。对照组行全喉切除术,观察组行CHEP。比较两组术后恢复情况、嗓音功能、吞咽功能、炎症因子水平及并发症。结果观察组术后引流量[(82.41±6.85)mL]低于对照组[(108.95±15.41)mL];观察组鼻饲、喉功能恢复、试吃开始及住院时间为(15.41±1.25)、(14.15±1.33)、(16.21±1.25)、(20.41±2.31)d,均短于对照组[(18.74±1.37)、(19.25±1.38)、(20.04±2.37)、(24.87±2.45)d],P均<0.05;观察组术后嗓音障碍指数量表中功能、生理及情感维度评分为(12.89±1.12)、(14.41±1.35)、(13.41±1.24)分,均低于对照组[(18.35±1.24)、(20.09±2.14)、(19.84±1.45)分],P均<0.05;观察组术后标准吞咽功能评价量表评分,C反应蛋白、白细胞介素-6、肿瘤坏死因子-α水平为(19.41±2.38)分,(9.95±1.24)mg/L、(7.89±1.14)ng/L、(7.25±1.07)ng/L,均低于对照组[(25.73±2.75)分、(12.41±2.05)mg/L、(9.87±1.25)ng/L、(9.63±1.12)ng/L],P<0.05。观察组并发症少于对照组(P<0.05)。结论CHEP对喉鳞状细胞癌治疗价值更高,可减轻手术创伤,便于术后嗓音功能及吞咽功能恢复,且并发症少。Objective To investigate the clinical efficacy of cricohyoidoepiglottopexy(CHEP)on laryngeal squamous cell carcinoma,and to analyze its influence on vocal and swallowing function.Methods Eighty-two patients with laryngeal squamous cell carcinoma admitted to the the First Affiliated Hospital of Zhengzhou University from January 2021 to October 2023 were selected for the cohort study.And they were divided into a control group and an observation group using a random number table method,with 41 cases in each group.The control group underwent total laryngectomy,while the observation group underwent CHEP.The postoperative recovery,vocal function,swallowing function,levels of inflammatory factors,quality of life,and complications were compared between the two groups.Results The postoperative drainage volume of the observation group was(82.41±6.85)mL,which was lower than the(108.95±15.41)mL of the control group(P<0.05).The nasogastric feeding time,laryngeal function recovery time,time of starting oral feeding,and hospital stay of the observation group were(15.41±1.25)d,(14.15±1.33)d,(16.21±1.25)d,and(20.41±2.31)d,which were shorter than the(18.74±1.37)d,(19.25±1.38)d,(20.04±2.37)d and(24.87±2.45)d of the control group(all P<0.05).The postoperative scores of function(12.89±1.12),physiology(14.41±1.35)and emotion(13.41±1.24)of voice handicap index in the observation group were lower than those in the control group(18.35±1.24,20.09±2.14,19.84±1.45),all P<0.05.The postoperative standardized swallowing assessment score,levels of C-reactive protein,interleukin-6,tumor necrosis factor-αof the observation group were 19.41±2.38,(9.95±1.24)mg/L,(7.89±1.14)ng/L,and(7.25±1.07)ng/L,respectively,which were lower than the 25.73±2.75,(12.41±2.05)mg/L,(9.87±1.25)ng/L,and(9.63±1.12)ng/L of the control group(P<0.05).The observation group had fewer complications than the control group(P<0.05).Conclusions CHEP has higher value in the treatment of laryngeal squamous cell carcinoma.It can reduce surgical trauma,facilit

关 键 词：鳞状细胞癌 喉 环状软骨上部分喉切除术 全喉切除术 嗓音功能 吞咽功能 

分 类 号：R739.65[医药卫生—肿瘤]