两种颈前带状肌瓣修复喉腔术后的喉功能比较

Comparison of laryngeal function between two groups of patients who were differently repaired with cervical strap muscles

目的 探讨如何更好地用颈前带状肌瓣对喉癌手术患者行喉功能重建。方法 回顾性分析了 117例垂直半喉及扩大垂直部分喉切除术或 3/ 4喉切除术后的喉功能 ,其中 71例用单蒂舌骨肌瓣修复喉腔 ,46例用双蒂带状肌瓣修复喉腔、重建喉功能。结果 舌骨肌瓣组 6 9例 (97 2 % )可发哑声 ,术后拔胃管时间 12～ 2 8d ,平均 15 6d ,气管套管拔除率 :T2 期病人92 3% ,T3 期 79 3 %。双蒂带状肌瓣组 46例 (10 0 % )均可发出哑声 ,术后拔胃管时间 10～ 2 1d ,平均 13 5d ,气管套管拔除率 :T2 期病人 10 0 % ,T3 期病人 6 0 %。结论 舌骨肌瓣修复的病人吞咽功能似乎恢复较慢 ,但该肌瓣修复的T3 期喉癌病人拔管率高。

WT5”BZ] Objective To study how to get the better laryngeal function by using two different repairing methods in patients with laryngeal carcinoma. Method A retrospective review was made on 117 patients who underwent vertical partial laryngectomy or three-fourths langectomy.Of these patients, 71 were repaired with hyoid osteomuscular flap and other 46 with bi-pedicled strap muscles. Results Of the patients repaired with the hyoid osteomuscular flap,69 (97.2%)could produce hoase voice,the extraction of stomach tubes was in postoperative 12～28 days(mean 15.6 days),and the decannulation rates of T 2 and T 3 patients were 92.3% and 79.3% respectively.The patients repaired with bi-pedicled strap muscles,46(100%) could produce hoase voice,the extraction of stomach tubes was in postoperative 10～21 days(mean 13.5 days),and the decannulation rates of T 2 and T 3 patients were 100% and 60% respectively. Conclusion The time of resuming normal mouth-food-taking in the patients repaired with the hyoid osteomuscular flap seems to be longer.The decannulation rate of the patients with T 3 laryngeal carcinoma and repaired patients with the hyoid osteomuscular flap is higher.