全喉切除术后咽瘘及切口感染的防治策略

Control strategies pharyngeal fistula after total laryngectomy and wound infection

目的探讨加强围手术期处理对防治喉癌全喉切除术后咽瘘的重要性。方法回顾性分析2000年1月—2004年1月和2004年2月—2010年1月两时段内第三军医大学西南医院收治的71例全喉切除术的病例资料,对其围手术期处理及术后咽瘘、切口感染发生情况进行比较。结果第二阶段通过加强喉癌围手术处理,术后咽瘘及切口感染的发生率由第一阶段的15.6%、12.5%降为第二阶段的5.1%、2.7%。其他如肺部感染、出血等术后并发症亦大为降低。术后咽瘘、切口感染的病例愈合时间明显缩短。结论加强围手术期处理可明显防治喉癌全喉切除术后咽瘘及切口感染的发生率,加快患者愈合。

Objective To explore the importance of the prevention of perioperative laryngeal pharyngeal fistula after total laryngectomy. Methods Retrospectively analyze from January 2000 to January 2004 and February 2004 to January 2010 during two periods of 71 patients treated in our department total laryngectomy cases information the perioperative and postoperative pharyngeal fistula,wound infection were compared. Results The second stage of laryngeal cancer by strengthening the perioperative treatment,postoperative pharyngeal fistula and wound infection rate from 15.6%,12.5% in the first stage,to 5.1%,2.7% in the second stage.Others such as pulmonary infection,and bleeding complications are greatly reduced.Postoperative pharyngeal fistula,wound infections was significantly shorter healing time. Conclusions Perioperative treatment could control laryngeal pharyngeal fistula after total laryngectomy and the incidence of wound infection and speed up the healing of patients.