全喉切除术中保留甲状软骨膜对手术进程和术后恢复影响的探讨

Reserch of the operating process and post-operating recovery of the patients undertaken the total laryngectomy reserving thyroid cartilage membrane

目的 :探讨保留甲状软骨膜对全喉切除手术进程和病人术后恢复情况的影响。方法 :在甲状软骨膜下游离甲状软骨并切断其上角。不结扎和切断舌骨下肌群和喉上动脉。保留之甲状软骨膜用以加强修复咽壁黏膜。结果 :本组病例较经典全喉切除术手术时间缩短 3 0min以上。手术中出血在 10 0ml以下。患者术后第 2d下床活动 ,第 4d开始进食流质。手术创口均一期愈合。结论 :全喉切除术中保留甲状软骨膜可有效地简化手术步骤 ,减少创伤和出血。利用甲状软骨膜加强咽壁黏膜缝合口 ,进一步减少了咽漏的发生。

Objective: To study the effects on the operating process and post-operating recovery of the patients undertaken the total laryngectomy reserving thyroid cartilage membrane. Methods: The thyroid cartilage and its superior horn was freed and cut under the thyroid cartilage membrane but its muscles and the superior laryngeal artery aren't cut. The membrane of the pharynx is reinforced with the reserved thyroid cartilage membrane. Results: The operation times in this cases was shorter than the classical total laryngectomy over half hour and the volume of bleeding during the operation was less than 100ml. The patients in this cases began to exercise at the second day after operation and eat liquid food at the forth day . Conclusion: Reserving the thyroid cartilage membrane during the total laryngectomy can simplify operating process, alleviate the trauma and reduce the bleeding.