全喉切除术后早期经口进食的临床观察

The clinical observation of early oral feeding following total laryngectomy

目的 :对喉癌、梨状窝癌行全喉切除术后早期经口进食进行可行性研究。方法 :42例行全喉切除术的患者 (其中喉癌 34例 ,梨状窝癌 8例 )随机分为两组 :观察组 2 1例 ,术后 48～ 72h经口进食 ;对照组 2 1例 ,按常规 10～ 12d经口进食。结果 :观察组咽瘘发生率为 4.8%(1/ 2 1) ,对照组为 9.5 %(2 / 2 1) ,两者差异无显著性意义(P >0 .0 5 ) ;观察组术后平均住院天数较对照组明显缩短。结论 :术前未行放疗的喉癌、梨状窝癌患者行全喉切除术后 48～ 72h经口进食是安全可行的。

Objective:To demonstrate the feasibility of oral feeding 48-72 hours after total laryngectomy of carcinoma of the larynx or pyriform sinus. Method:Forty-two patients underwent total laryngectomy (included 34 patients of larynx carcinoma and 8 patients of pyriform sinus carcinoma) were random categorized into control group and experimental group. The experimental group of 21 patients who received oral feeding 48 to 72 h after total laryngectomy was compared with the control group of 21 patients who received oral feeding 10 to 12 days. Result:Pharyngocutaneous fistula occurred in one patient ( 4.8%) in the experimental group and in two patients ( 9.5%) in the control group. These differences were not statistically significant (P> 0.05). The length of hospital stay was significantly shorted.Conclusion:Our results indicate that in the patient population initiation of oral feeding 48 to 72 h after total laryngectomy of carcinoma of the larynx or pyriform sinus is a safe clinical practice.