喉额-侧切除术的临床应用  

Application of frontal-lateral laryngectomy in laryngeal cancer treatment

作　　者：赵瑞力[1] 胡俊兰[1] 葛俊恒[1] 周维安[1] 

机构地区：[1]河北医科大学第四医院耳鼻咽喉-头颈外科,石家庄050011

出　　处：《中华耳鼻咽喉科杂志》2003年第1期7-9,共3页Chinese Journal of Otorhinolaryngology

基　　金：河北省科委 2 0 0 1年攻关课题 (0 12 7612 2 33)

摘　　要：目的　对 3 8例喉癌患者行改良Tucker手术 (喉额 侧切除术 ) ,进行回顾性分析 ,并就修复材料的选择进行评价。方法　自 1988年 2月～ 2 0 0 0年 2月采用会厌瓣、双蒂双肌瓣以及会厌瓣 +双蒂双肌瓣联合修复喉缺损。其中男 2 9例 ,女 9例 ;年龄 3 2～ 72岁 ,平均 63岁。 8例患者行同期颈清扫术 ,4例于术后行Ⅱ期颈清扫术。声门型癌 3 6例 ,声门上型癌 2例。T2期病变 16例 ,T3病变 2 2例。结果　术后患者误吸较轻 ,均于术后 10～ 15d进食 ,术后拔管率为 97 3 % (3 7/ 3 8)。 3例术后发生伤口感染 ,1例发生软骨完全坏死并发生咽瘘。 3、5年生存率分别为 86 1% (3 1/ 3 6)和 83 9% (2 6/ 3 1)。结论　该手术操作简单 ,取材方便 ,创伤小 ,手术效果好 ,是一种值得推荐的修复方法。但该手术适应证局限 。Objective Thirty eight patients of laryngeal cancer were treated by extended frontal lateral laryngetomy and the results were evaluated Methods Thirty eight patients with laryngeal cancer were treated by frontal lateral laryngetomy and the laryngeal defects were reconstructed by epiglottic flap, bi pedicle and bi muscle flap and epiglottic flap plus bi pedicle and bi muscle flap from February 1988 to February 2000 There were 29 males and 9 females, ranging in age from 32 to 72 years old Radical neck dissection was performed in 12 patients 36 cases belonged to glottic cancer and 2 was superglottic cancer (T2 16, T3 22) Results The aspiration was light and the majority of cases began to eat in 10～15 days after operation The decannulation rate was 97 3%(37/38) Wound infection occurred in 3 cases,but pharyngocutaneous fistula was not found The three and five years survival rates were 86 1%(31/36) and 83 9%(26/31) respectively Conclusion This procedure present an ideal effect and is worthy to be recommended, but only the indication is limited

关 键 词：喉切除术 临床应用 喉肿瘤 外科皮瓣 

分 类 号：R739.65[医药卫生—肿瘤]