喉部分切除术后喉狭窄的原因分析及治疗

Pathogeny and treatment of laryngeal scar stenosis after partial laryngectomy

目的探讨喉部分切除术后瘢痕性喉狭窄的病因及治疗。方法回顾近13年喉部分切除术后瘢痕性喉狭窄患者32例临床资料，分析导致喉狭窄可能原因以及根据喉狭窄的范围和程度，应用不同手术方法处理的经验、效果。结果32例患者4例患者放弃治疗，其余经一次或多次手术，有24例重新恢复正常呼吸，拔管率85．7％。结论支架切除过多及瘢痕肉芽组织增生是导致喉部分切除术后喉狭窄的主要原因。根据喉狭窄的范围和程度采用不同的手术方法，可以使大部分患者拔管，恢复正常呼吸。

Objective To investigate the pathogeny and treantment of laryngeal scar stenosis after par- tial laryngectomy. Methods The data of 32 cases with laryngeal scar stenosis after partial laryngectomy about ten years were reviewed, date included clinic factors and experience about operation. 8 cases could not decannu- kate postoperative and 24 cases developed dyspnea after an initial period of successful decannulation. Results Four cases gave up treating,twenty-four cases were decannulated successfully after one or more operations, de- cannulation rate was 85.7%. Conclusion Overextension of resection and the scar granulation tissue hyperpla- sia is the major causes of laryngeal stenosis. Most of patients could decannulate after choicing adequate treatment