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目的探讨声门上水平喉部分切除术中保留与切除舌骨对误咽的影响。方法回顾分析1998年1月至2011年10月菏泽市立医院耳鼻咽喉科收治的39例声门上型喉癌行声门上水平喉部分切除术的临床资料,将其中年龄在56~67岁且无脑血管病、神经系统疾病及呼吸系统疾病的声门上型喉癌(T1~T3)行声门上水平喉部分切除术的39例患者作为观察对象,其中19例未切除舌骨,20例切除舌骨。结果病例切缘均为阴性,发声接近正常,拔管率为100%;保留舌骨的19例中,2例(10.5%)有轻度误咽,10例(52.6%)中度误咽,7例(36.8%)重度误咽,误咽恢复时间为(31±3)d;2例并发吸入性肺炎。切除舌骨的20例中,轻度误咽11例(55.0%),中度误咽9例(45.0%),无重度误咽,误咽恢复时间为(15±2)d;无吸入性肺炎发生。结论声门上水平喉部分切除术中切除舌骨、充分利用舌根对声门的遮盖作用,可有效减轻术后误咽程度,缩短误咽恢复时间,防止或减少吸入性肺炎的发生。
Objective To investigate the effect of preserving and removing the hyoid on the supraglottic partial laryngectomy. Methods The clinical data of 39 patients with supraglottic laryngeal carcinoma undergoing supraglottic laryngectomy admitted from otolaryngology department of Heze Municipal Hospital from January 1998 to October 2011 were retrospectively analyzed. The clinical data of 56 patients aged from 67 to Thirty-nine patients with supraglottic laryngectomy for supraglottic laryngeal carcinoma (T1-T3) without cerebrovascular disease, neurological disease and respiratory system were selected as the observation object. Nineteen patients had no hyoid bone and 20 Example of removal of the hyoid bone. Results All cases had negative margins, with normal vocalization and 100% extubation rate. Of the 19 cases with hyoid bone remaining, 2 (10.5%) had mild swallow and 10 (52.6%) had moderate swallow, Seven patients (36.8%) had severe swallowing and swallowing recovery time was (31 ± 3) d. Two patients had aspiration pneumonia. There were 11 cases (55.0%) of mild swallowing, 9 cases (45.0%) of moderate swallowing, no severe swallowing and (15 ± 2) d of swallowing. There was no inhalation Pneumonia occurs. Conclusions The removal of the hyoid bone in the supraglottic partial laryngectomy and the full use of the lingual root to cover the glottis can effectively reduce the degree of postoperative inpharyngeal pharynx, shorten the recovery time of vomiting, and prevent or reduce the occurrence of aspiration pneumonia.