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目的:探讨扩大声门上水平喉部分切除术对中晚期喉癌及会厌谷癌的治疗效果及术后功能恢复的作用。方法:对44例喉癌患者均行扩大声门上水平喉部分切除术,即在原有声门上水平喉部分切除术基础上扩大切除范围,并对其术后生存及喉的呼吸、发声及吞咽功能恢复情况进行随访。结果:本组患者2年和3年生存率分别为72.7%和71.4%。术后随访无局部复发病例,死亡患者均由于颈部淋巴结转移或廓清后颈淋巴结复发。本组病例拔管率为97.7%(43/44)。术后42例(95.5%)发声良好,其余2例行杓状软骨部分切除患者发声中等。患者术后存在不同程度误咽,但经过练习后最终都拔除鼻饲。结论:扩大声门上水平喉部分切除术能够彻底切除肿瘤,术后喉部呼吸、吞咽和发声功能恢复满意。
Objective: To investigate the effect of augmented supraglottic horizontal laryngectomy on the treatment of advanced laryngeal carcinoma and epiglottis carcinoma and the postoperative functional recovery. Methods: Forty-four patients with laryngeal cancer were enrolled in the study. The patients were followed up with partial laryngectomy on the supraglottic, which was to expand the resection scope on the basis of the original horizontal partial laryngectomy on the supraglottic gland. The postoperative survival and laryngeal respiration, vocalization and swallowing Functional recovery was followed up. Results: The 2-year and 3-year survival rates of patients in this group were 72.7% and 71.4% respectively. No cases of local recurrence after follow-up, death patients were due to cervical lymph node metastasis or clearance of neck lymph node recurrence. The rate of extubation in this group was 97.7% (43/44). 42 cases (95.5%) had sound good after operation, while the remaining 2 patients had moderate pharyngeal sound in partial resection of arytenoid cartilage. Patients with varying degrees of postoperative swallow, but after the final removal of nasal feeding. Conclusions: Enlarged supraglottic horizontal throat resection can completely remove the tumor, postoperative laryngeal respiration, swallowing and vocal function recovery satisfactory.