喉全切除术后Blom-Singer发音管的临床应用

Clinical Use of Tracheo-oesophageal Voice Prostheses After-laryngectomy

目的 分析Blom -Singer发音管在喉全切除术患者中的应用效果。方法 1995～ 1999年期间为 18例因喉癌行喉全切除的患者安装了气管食管发音管 ,12例行一期发声重建术 ,6例行二期发声重建术。全部采用Blom -Singer发音管。结果 本组病例均随访 3～ 5年 ,无死亡。本组成功者 14例 ,成功率为 77.8%。带管时间 8～19月不等 ,平均为 12月。换管次数最多的为 6次。无严重并发症。失败者均为二期手术者。结论 凡喉全切除术者均可行一期发声重建术 ,二期手术的适应症必须严格控制。应重视术后发声训练 ,对于食管发声无效的喉全切除患者 ,气管食管发声重建术是一种有效的补充方法 。

Objective The purpose of this study was to evaluate the use of tracheo-oesophageal vioce prostheses after total laryngectomy.Methods Between 1995 and 1999,18 male patients ,Aged from 42 to 68,average 54.6,used Blom-singer voice prostheses after total laryngectomy.10 cases were glottic style,8 cases were subglottic style.12 patients received stage I,6 patients received stage Ⅱ voice reconstruction surgery. Results All cases were followed-up from 3 to 5 years. The success rate was 77.8%(14/18). The time with prostheses ranged from 8 to 19 months(average 12months). All failures were stage Ⅱ surgey .Conclusion Stage I voice reconstruction surgery can be performed in all total laryngectomy patients. But the indications of stage Ⅱ voice reconstruction surgery should be controlled strictly. More attention should be paid to the training of voice rehabilitation after total laryngectomy. The tracheo-oesophageal voice prostheses is an effective method to improve the life quality of the patients.