梨状窝粘膜修复喉部分切除术后的粘膜缺损  

Reconstruction with pyriform sinus mucosa in partial laryngectomy

作　　者：林鹏[1] 杨宝琦[1] 

机构地区：[1]天津市第一中心医院耳鼻咽喉-头颈外科,天津市耳鼻咽喉科研究所天津300192

出　　处：《临床耳鼻咽喉科杂志》2002年第12期665-666,共2页Journal of Clinical Otorhinolaryngology

摘　　要：目的 :探讨应用梨状窝粘膜修复喉部分切除术后粘膜缺损及恢复喉功能的效果。方法 :对 198例患者施行此术式 ,其中喉水平部分切除术 87例、喉垂直部分或扩大喉垂直部分切除术 6 5例、喉水平加垂直部分切除术 4 6例。同时进行随访观察。结果 :喉水平部分切除术者拔管率为 10 0 % ;术后发音、呼吸、吞咽功能恢复好 ;5年生存率为 84 .7%。喉垂直部分或扩大喉垂直部分切除术拔管率为 87.7% ;5年生存率 86 .2 % ;术后吞咽、呼吸功能恢复好 ,但有声音嘶哑。喉水平加垂直部分切除术后初期进食呛咳较重 ,训练适应时间较长 ,拔管率为82 .6 % ;5年生存率为 78.3% ;术后声音嘶哑 ,部分患者喉狭窄导致拔管困难。结论 :本方法操作简单 ,取材方便 ,手术时间较短 ,成活率高 ,术后喉功能保留好 ,患者的 5年生存率高。Objective:To assess the effectiveness of reconstruction with pyriform sinus mucosa in partial laryngectomy and resumed laryngeal function. Method:A total of 198 cases of laryngeal cancer who had undergone partial laryngectomy from 1980 to 1995 in our hospital were retrospectively reviewed. Defect of larynx were repaired with pyriform sinus mucosa in all cases. Surgery of local lesions: 87 cases underwent supraglottic horizontal partial laryngectomy, 65 vertical or extended vertical partial laryngectomy, 46 horizontal vertical partial laryngectomy.Result:In cases underwent supraglottic horizontal partial laryngectomy, postoperative decannulation rate is 100%,5 year survival rate is 84.7 0% and functions of voice, respiration and deglutition were all preserved well. In cases underwent vertical or extended vertical partial laryngectomy, decannulation rate is 87.67 % and 5 year survival rate is 86.15 %. Functions of respiration and deglutition are good but existent hoarseness. In the earlier stage after operation, there was serious aspiration in the cases underwent horizontal vertical laryngectomy and it took patients more time to overcome aspiration by practice. In this group, decannulation rate is 82.60 % and 5 year survival rate is 78.26 %. all cases present hoarseness and part of them can't be extubated because of glottic stenosis. Conclusion:The authors believe that this method of surgery is safe and beneficial to some patients with partial laryngectomy. Laryngeal functions can be well preserved with this technique.

关 键 词：喉部分切除术 梨状窝粘膜 喉功能 修复术 喉癌 治疗 

分 类 号：R739.650.5[医药卫生—肿瘤]