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目的 :探讨治疗喉癌术后复发及颈部转移的有效方法。方法 :回顾性分析我院 1990年 4月～ 1998年 4月收治的喉癌术后复发及颈部转移患者 70例 ,其中局部复发癌 31例 ,气管造口复发癌 15例 ,颈淋巴结转移2 4例。结果 :31例局部复发癌中 ,19例二次手术者术后 15例生存 ,4例死亡 ;未行手术治疗的 12例分别在 1～ 3年内死亡。 15例气管造口复发癌中 ,9例二次手术者术后 5例生存 ,4例死亡 ;未行手术治疗的 6例均在 18个月内死亡。 2 4例颈淋巴结转移者中 ,15例二次手术者术后 8例生存 ,7例死亡 ;9例未行Ⅱ期手术者 2年内死亡。结论 :喉癌术后定期复查及系统的临床随访 ,有利于喉癌术后复发及颈部转移的早期发现和早期治疗 ;二次手术是喉癌术后复发及颈部转移临床治疗的重要措施 ;放射治疗或化学治疗作为综合治疗手段有一定疗效 ,但其疗效有限。
Objective: To study the effective treatment of recurrence and neck metastasis of laryngeal cancer. Methods: A retrospective analysis of our hospital from April 1990 to April 1998 were treated postoperative recurrence of laryngeal cancer and neck metastases in 70 patients, including 31 cases of local recurrence of cancer, recurrent tracheostoma in 15 cases of cervical lymph node metastasis 2 4 cases. Results: Of the 31 patients with locally recurrent cancer, 19 of the 19 secondary surgeries survived and 4 died after surgery. Twelve patients who did not undergo surgery died within 1 to 3 years respectively. In 15 cases of tracheostoma recurrent carcinoma, 5 of the 9 secondary surgeries survived and 4 died after surgery. All 6 patients who did not undergo surgery died within 18 months. Of the 24 cases with cervical lymph node metastasis, 15 of the 15 secondary surgeries survived after operation and 7 died. Nine patients died without operation within 2 years. CONCLUSIONS: Regular postoperative recheck and systematic follow-up of laryngeal cancer are helpful for the early detection and early treatment of postoperative recurrence and neck metastasis of laryngeal cancer. The secondary surgery is an important measure for the clinical treatment of laryngeal cancer recurrence and neck metastasis ; Radiation therapy or chemotherapy as a comprehensive treatment has a certain effect, but its efficacy is limited.