会厌在喉部分切除喉功能重建术中的应用

The application of epiglottis in laryngeal function reconstruction after partial laryngectomy

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 1 992年 1 2月～1 996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 2 1例声门型喉癌术后 1 9例拔除气管套管恢复喉的全部功能 ;1 1例声门上型喉癌 5例恢复喉全部功能 ,并于术后 1 4～ 1 8d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 %(2 8/ 32 ) ,5年生存率 5 8 3%(7/ 1 2 )。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。

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