喉切除环（气管）咽吻合术中切断环咽肌的临床意义

Clinical significance of cricopharyngeal myotomy during cricopharyngeal or tracheopharyngeal anastomosis after laryngectomy

报告在喉切除环（气管）咽吻合术中，同时切断环咽肌２５例（切断组），与未切断的２８例（未切组）进行比较。结果切断组术后鼻饲天数明显少于未切组，差异有极显著意义（Ｐ＜０．０１）；切断组术后无一例发生吞咽困难，与未切组之间差异显著（Ｐ＜０．０５）；而两组咽瘘的发生率差异无显著性（Ｐ＞０．０５）。故认为术中切断环咽肌方法简单，效果确实，对预防术后环咽失弛缓症及促进吞咽功能的恢复、缩短鼻饲时间有积极的意义。

Abstract Cricopharyngeal myotomies were performed in 25 cases during cricopharyngeal or trachcop haryngcal anastomosis a fter laryngectomy and the clinical curative effects were co mpared with the eliminatiOn of myotomy in 28 caese as control. The results showed that nasal feeding days of the myotomy group were less than the control group(P<0.01),that no patient happened postoperative dysphagia in the myotomy group,in comparison with that in the control group the difference was evident (P<0.05),and that the pharyngeal fistula incidence rates were similar in both groups without statistical significance(P>0.05).Therefore cricopharyngeal myotomy is simple and effective fOr the prevention of cricopharyngeal achalasia ,for the promotion of the swallowing function recovery and for the reduction of postoperative nasal feeding time.