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目的:探讨和评价喉癌喉部分切除喉功能重建的手术方法。方法:265例喉癌患者喉部分切除术后同期采用会厌瓣、颈前胸骨舌骨肌肌筋膜瓣、会厌瓣加胸骨舌骨肌肌筋膜瓣联合修复喉缺损。其中79例同期行颈淋巴结清扫术。结果:265例患者鼻饲管于术后10~15d拔除。术后拔除气管套管218例,拔管率为82.26%。12例术后发生伤口感染,其中2例发生咽瘘。3、5年生存率分别是74.72%、70.88%。结论:喉部分切除术后应用胸骨舌骨肌肌筋膜瓣、会厌瓣Ⅰ期喉功能重建,手术操作简单,取材方便,创伤小,成活率高,手术效果好,是值得推广的手术方法。
Objective: To investigate and evaluate the operative methods of throat partial laryngectomy reconstruction in laryngeal cancer. Methods: A total of 265 patients with laryngeal carcinoma were treated with pharyngeal hypopharyngeal flap, anterior cervical sternohyoid muscle fascia flap, epiglottis flap combined with sternohyoid myofascial flap to repair laryngeal defect. 79 cases of cervical lymph node dissection at the same period. Results: The nasogastric tube of 265 patients was removed 10 to 15 days after operation. 218 cases of tracheal tube removed after operation, extubation rate was 82.26%. 12 cases of wound infection occurred, of which 2 cases of pharyngeal fistula occurred. The 3-year and 5-year survival rates were 74.72% and 70.88% respectively. Conclusions: Thoracic hyoid muscle myofascial flap is applied after throat resection, and the function of stage Ⅰ laryngeal reconstruction of the metacarpal flap is simple. The operation is simple, the material is easy to draw, the trauma is small, the survival rate is high and the operation effect is good. It is worth to popularize the surgical method.