喉癌切除后发音重建的临床研究

Clinical analysis of speech rehabilitation after laryngectomy in patients with laryngeal carcinoma

本文就1975年～1995年8月间收治的资料完整的95例喉癌手术方式、喉功能恢复及生存率进行分析。97．9％（93／95）的患者吞咽功能良好，80．0％（76／95）发音良好。部分喉切除拔管率为59.5％（22／37）。全喉切除术1、3、5年生存率分别为88.1％、82.4％、76．9％；部分喉切除术1、3、5年生存率分别为86．7％、78．3％、68.4％。按临床分期统计生存率：Ⅰ～Ⅱ期患者1、3、5年生存率为91．2％、83．3％、81．3％，Ⅲ～Ⅳ期患者1、3、5年生存率为84.6％、78．1％、69．2％。

Ninety-five patients with laryngeal carcinoma were treated by surgery (total laryn-gectomy in 58, near-total laryngectomy in 6, partial laryngectomy in 29, and Arslan's laryngectomy in 2) from 1975 to 1995 in our hospital. Threr were 86 males and 9 fe-males, ranging in age from 16 to 75 years. Clinical stage of patients were Ⅰ in 27, Ⅱ in 29, Ⅲ in 10, and Ⅳ in 10. The speech rehabilitation of voice operation was performed in all patients. Our results showed that 76 cases had understandable speech. Swallow function was good in 97. 9%. Postoperative decarnulation rate was 59. 5% in partial la-ryngectomy (22 in 37). The 1-year, 3-year, and 5-year survival rates were 88. 1%,82. 4%, and 76. 9%, respectively in total laryngectomy; and 86. 7%, 78. 3%, and 68. 4% in partial laryngectomyl and 91. 2%, 83. 3%, and 81. 3% in stage Ⅰ and Ⅱ;and 84. 6%, 78. 1%, and 69. 2% in stage Ⅲ and Ⅳ. Different methods of speech reha-bilitation of voice on patients with laryngectomy were evaluated.