点击显示 收起
摘 要：目的 探讨会厌在喉部分切除喉功能重建术中的应用价值。方法 1992年12月～1996年1月32例不同分期的声门型、声门上型喉癌行喉部分切除术，将残存会厌下移保留喉功能。结果 21例声门型喉癌术后19例拔除气管套管恢复喉的全部功能；11例声门上型喉癌5例恢复喉全部功能，并于术后14～18 d恢复吞咽功能，无1例出现误吸引起严重并发症。3年生存率87.5％（28/32）,5年生存率58.3%（7/12）。结论 喉部分切除喉功能重建术中会厌取材方便，无需重新进行皮肤切口；其喉面有完整粘膜，创面愈合时间短；喉结构重建扩大了喉的左右径，提高了术后拔管率同时防止误咽发生，对提高喉部分切除术患者术后生存质量有一定作用。
The application of epiglottis in laryngeal function reconstruction after partial laryngectomy
HAN Demin
(Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Beijing Tongren Hospital, Capital University of Medical Sciences, Beijing 100730, China)
YU Zhenkun
(Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Beijing Tongren Hospital, Capital University of Medical Sciences, Beijing 100730, China)
HUANG Zhigang
(Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Beijing Tongren Hospital, Capital University of Medical Sciences, Beijing 100730, China)
Abstract：Objective To observe the appliance value of epiglottis in laryngeal function reconstruction after partial laryngectomy.Methods Thirty-two cases of glottic and superglottic carcinomas of larynx had conducted partial laryngectomy and the laryngeal function was reconstructed using epiglottis from December. 1992 to January 1996.Results Nineteen of the twenty-one glottic carcinomas and five of eleven supraglottic carcinomas were decannulated and recovered with laryngeal functions. All the patients rehabilitated deglutition in 14-18 days after surgery. None presented complication of aspiration.Conclusions Epiglottis has many advantages in partial laryngectomy and the laryngeal reconstruction. It is easy to approach, apply and heal in short period. It also prevents aspiration and improves the decannulation rate as well as the quality of life in partial laryngectomy patients.
Key words：Laryngeal neoplasms；Laryngectomy；Surgery, operative；Survival rate▲
喉部分切除一期喉功能重建术是喉癌外科的常用手术方法，切除病变后，利用残存的健康喉组织及附近结构重建喉的结构，恢复喉功能。我科1992年12月～1996年1月将残存会厌应用于喉部分切除喉功能重建术共32例，报道如下。
材料与方法
一、临床资料
32例喉癌患者，术前活检病理全部诊断为鳞状细胞癌。男25例，女7例，年龄43～76岁，平均56.6岁。声门型21例中T2N0 10例，T3N0 8例，T3N1 3例；声门上型11例中T2N0 3例，T2N1 4例，T3N1 2例，T3N2 2例；手术同期行同侧选择性颈清扫术（局部淋巴结清扫术）10例，根治性颈清扫术7例，同侧根治性加对侧选择性颈清扫术2例。