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目的探讨异种脱细胞真皮基质修复膜修复喉部分切除术喉腔缺损的可行性。方法回顾性分析62例喉癌患者的临床资料,经喉部分切除术,分别以颈部皮瓣(33例)和异种脱细胞真皮基质修复膜(29例)修复喉腔,分析两组的一期愈合率、拔管率和术后感染率。应用SPSS 18.0软件进行χ2检验。结果颈部皮瓣修复组颈部切口一期愈合26例,一期愈合率为81.8%;术后10~14 d出现感染性喉瘘7例,感染率为18.2%,经局部换药于20~33 d愈合;拔管24例,拔管率为72.7%;3年复发率为6.1%,3年生存率为97.0%。修复膜修复组颈部切口一期愈合28例,一期愈合率为96.6%;1例感染,感染率为3.4%,经局部换药愈合;拔管22例,拔管率为75.9%;3年复发率为3.4%,3年生存率为100%。修复膜修复组一期愈合率明显高于颈部皮瓣修复组,差异有统计学意义(P<0.05),而两组术后拨管率及3年复发率的差异均无统计学意义(P>0.05)。结论采用异种脱细胞真皮基质修复膜修复喉腔缺损,临床效果良好。
Objective To investigate the feasibility of repairing laryngectomy with partial acellular dermal matrix repair for partial laryngectomy. Methods The clinical data of 62 patients with laryngeal cancer were retrospectively analyzed. Throat resection was performed in 33 patients with throat flap and 29 patients with xenogenic acellular dermal matrix repair, The healing rate, extubation rate and postoperative infection rate. The χ2 test was performed using SPSS 18.0 software. Results In the neck flap repair group, 26 cases of primary incision healed in one stage, the rate of primary union was 81.8%. In the postoperative 10-14 days, 7 cases of infectious laryngeal fistula occurred, the infection rate was 18.2% ~ 33 days. Extubation was performed in 24 cases. The rate of extubation was 72.7%. The 3-year recurrence rate was 6.1% and the 3-year survival rate was 97.0%. In the repair group, 28 cases of primary incision healed in one stage, the rate of primary healing was 96.6%. One case was infected with the infection rate of 3.4% and healed by local dressing. Out of the 22 cases, the rate of extubation was 75.9% .3 The annual recurrence rate was 3.4% and the 3-year survival rate was 100%. The primary healing rate of the repaired membrane repair group was significantly higher than that of the cervical skin flap repair group (P <0.05), while there was no significant difference between the two groups in the rate of postoperative dialysis and the 3-year recurrence rate (P < P> 0.05). Conclusion Acellular dermal matrix repair membrane repair laryngeal defects, the clinical effect is good.