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目的:探讨喉癌患者术后气管感染与肺功能损伤及肿瘤复发的关系。方法:对86例喉癌患者进行回顾性分析,比较不同手术类型、手术时间的患者气管感染率,并分析术后气管感染与肺功能损伤及肿瘤复发的关系。结果:全喉切除联合颈淋巴结清扫组气管感染率显著高于全喉切除组[32.5%(13/40)vs 4.3%(2/46),P<0.05]。手术时间<4h、4~6h、>6h的气管感染率分别为2.5%(1/40)、19.4%(6/31)、53.3%(8/15),组间比较差异均有统计学意义(P<0.05)。2组手术时间与气管感染率呈正相关(r=0.41,P<0.01)。与术前相比,术后气管感染组患者FEV1%显著升高,V25显著降低(P<0.05)。术后气管感染的患者肿瘤复发率与未感染者的复发率分别为13.3%(2/15)和9.9%(7/71),二者比较差异无统计学意义(P>0.05)。结论:喉全切术患者易发生气管感染及肺功能损伤,且气管感染对肿瘤复发无明显影响。
Objective: To investigate the relationship between postoperative tracheal infection and pulmonary function impairment and tumor recurrence in laryngeal cancer patients. Methods: A total of 86 patients with laryngeal cancer were retrospectively analyzed. The tracheal infection rates of patients under different operation types and operation time were compared. The relationship between postoperative tracheal infection and pulmonary function injury and tumor recurrence were analyzed. Results: The rate of tracheal infection in total laryngectomy combined with cervical lymph node dissection was significantly higher than that in total laryngectomy [32.5% (13/40) vs 4.3% (2/46), P <0.05]. The tracheal infection rates were 2.5% (1/40), 19.4% (6/31) and 53.3% (8/15) respectively at the time of operation <4h, 4 ~ 6h and> 6h, with significant difference between the two groups (P <0.05). There was a positive correlation between operation time and tracheal infection rate in the two groups (r = 0.41, P <0.01). Compared with the preoperative, tracheal infection group postoperative FEV1% significantly increased, V25 was significantly lower (P <0.05). The recurrence rate of patients with tracheal infection was 13.3% (2/15) and 9.9% (7/71), respectively. There was no significant difference between the two groups (P> 0.05). CONCLUSION: Tracheotomy and pulmonary dysfunction are easy to occur in patients undergoing total laryngectomy, and tracheal infection has no obvious effect on tumor recurrence.