喉全切除术后咽皮瘘的治疗和相关因素分析  

An Analysis on the Management and Relative Factors of Pharyngocutaneous Fistula after Total Laryngectomy

作　　者：刘巍巍[1] 曾宗渊[1] 陈直华[1] 伍国号[1] 区深明[1] 

机构地区：[1]中山大学肿瘤防治中心,广东广州510060

出　　处：《中国肿瘤》2004年第6期389-391,共3页China Cancer

摘　　要：[目的]探讨喉全切除术后咽皮瘘的发生率、治疗效果和发生相关因素。[方法]回顾1990年至1995年于中山大学肿瘤防治中心住院治疗的107例行喉全切除术的患者,应用SPSS统计软件统计分析术后咽皮瘘的发生率、治疗效果和发生相关因素。[结果]全喉切除术后14.0%(15/107)的患者出现咽皮瘘。全喉切除术后至发生咽皮瘘的间隔时间5至28天,平均11天。80%(12/15)的患者保守治疗后可以自行愈合。保守治疗后咽皮瘘的愈合间隔时间介于12至90天,平均37天。3例无法自行愈合的咽皮瘘患者中,1例出现咽皮瘘口周围肿瘤复发,其余2例则需要手术修补。分析与喉全切除术后咽皮瘘发生有关的可能因素显示,首次治疗后复发再行喉全切除术挽救、喉全切除术前接受过放疗以及喉全切除术后伤口感染是影响咽皮瘘发生的显著因素。[结论]喉全切除术后咽皮瘘较为常见,发生后以保守治疗为主。初次治疗失败、术前放疗以及伤口感染可能是喉全切除术后咽皮瘘发生的相关因素。To investigate the incidence,treatment and relative factors of pharyngocutaneous fistula(PCF) after total laryngectomy (TL).One hundred and seven patients with laryngeal cancer underwent TL hospitalized in Cancer Center of Sun Yat-sen University(from 1990 to 1995)were reviewed.SPSS software was used to summarize statistically the incidence,treatment and relative factors of PCF.There were 14.0% (15/107) of patients who presented PCF after TL. The interval of PCF after TL ranged from 5 to 28 days, with a mean 11 days. 80% (12/15) of patients recovered spontaneously after conservative treatment.The time interval of recovery of PCF ranged from 12 to 90 days after conservative treatment, with a mean interval of 37 days. Among three patients who did not recover, one patient was found tumor recurrence near the site of PCF and the other two patients needed surgery to repair the defect. The relative possible factors for PCF after TL were analyzed.It was shown that TL salvage,surgery after primary treatment failure pre-operation radiotherapy and wound infection after TL were the significant factors influencing PCF.[Conclusions]PCF after TL is rather common in clinical.The management for PCF is mainly conservative.Primary treatment failure,pre-operation radiotherapy and wound infection after TL might be the significant relative factors for the presentation of PCF after TL.

关 键 词：喉肿瘤 咽皮瘘 全喉切除术 治疗 

分 类 号：R739.65[医药卫生—肿瘤]