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目的:探讨喉癌手术治疗的方法与喉功能重建疗效分析。方法:对1995~2007年收治的46例喉癌患者进行手术治疗。声门上型癌13例中Ⅰ期1例,Ⅱ期4例,Ⅲ期6例,Ⅳ期2例。声门型癌33例中Ⅰ期10例,Ⅱ期8例,Ⅲ期15例。根据不同病变情况采用相应的手术方式。结果:喉部分切除术占全部手术病例的73.9%(34/46),喉部分切除术的拔管率为76.5%(26/34),23例Ⅲ、Ⅳ期患者中喉部分切除术11例(47.8%)。全部患者恢复经口进食,喉部分切除患者均恢复发音。46例喉癌患者3年生存率为79.6%,5年生存率为70.2%。Ⅲ、Ⅳ期喉部分切除患者的3年生存率为73.5%,5年生存率为66.2%,Ⅲ、Ⅳ期全喉切除术患者的3年生存率为80.4%,5年生存率为68.6%,差异无统计学意义(P>0.05)。结论:晚期喉癌保留喉功能是可行的,熟练掌握、择优采用各种修复方法可提高喉功能保留率。
Objective: To investigate the surgical treatment of laryngeal cancer and throat functional reconstruction of the efficacy analysis. Methods: Surgical treatment was performed on 46 cases of laryngeal cancer admitted from 1995 to 2007. Of the 13 cases of supraglottic carcinoma, 1 was stage Ⅰ, 4 was stage Ⅱ, 6 was stage Ⅲ, and 2 was stage Ⅳ. Of the 33 cases of glottic carcinoma, 10 cases were stage Ⅰ, 8 cases were stage Ⅱ and 15 cases were stage Ⅲ. According to different pathological conditions using the appropriate surgical approach. Results: The total laryngectomy accounted for 73.9% (34/46) of the total cases, and the laryngectomy rate was 76.5% (26/34). Among 23 patients with stage Ⅲ and Ⅳ laryngectomy, 11 (47.8%). All patients recovered oral intake, partial laryngectomy patients were recovered. 46 cases of laryngeal cancer patients with 3-year survival rate was 79.6%, 5-year survival rate was 70.2%. The 3-year and 3-year survival rates were 73.5% and 66.2% respectively in patients with stage III and IV partial laryngectomy. The 3-year survival rate was 80.4% in stage III and IV total laryngectomy, and the 5-year survival rate was 68.6% , The difference was not statistically significant (P> 0.05). CONCLUSION: Laryngeal function preserved in advanced laryngeal cancer is feasible and proficient. Various repair methods can be used preferentially to improve laryngeal function retention rate.