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目的研究喉部分切除术治疗喉鳞状细胞癌的临床疗效。方法手术术式的选择:喉裂开一侧声带切除;水平部分喉切除术;垂直部分喉切除;3/4喉切除术;次全喉切除术。修复方法:颈前肌皮瓣修复;颈深筋膜浅层筋膜瓣修复;颈前带状肌肌筋膜瓣修复;会厌瓣修复;会厌瓣+颈前带状肌肌筋膜瓣修复;残留的喉腔黏膜缝合成发音管。结果64例中,随访满3年有62例,死亡8例,失访3例。随访满5年者61例,死亡15例,失访3例。失访按死亡计算,其3、5年生存率分别为82.81%(53/64)、71.88%(46/64)。呼吸功能术后拔除气管套管57例,因喉腔狭窄及局部复发未能拔管者7例,拔管率为89.06%(57/64)。结论喉部分切除术,值得在临床上推广应用。
Objective To study the clinical efficacy of partial laryngectomy in the treatment of laryngeal squamous cell carcinoma. Methods Surgical options: vocal cords on the side of laryngeal rupture; horizontal partial laryngectomy; vertical partial laryngectomy; 3/4 laryngectomy; subtotal laryngectomy. Repair methods: anterior cervical myocutaneous flap repair; superficial cervical fascia flap fascial repair; anterior cervical myofascial flap repair; epiglottis flap repair; epiglottis flap + anterior cervical myofascial flap repair; Residual throat mucosa suture into the sound tube. Results Of 64 cases, 62 cases were followed up for 3 years, 8 died and 3 cases were lost to follow-up. 61 cases were followed up for 5 years, 15 cases were lost and 3 cases were lost to follow-up. The loss of follow-up calculated by death, the 3, 5-year survival rates were 82.81% (53/64), 71.88% (46/64). Fifty-seven cases of tracheal tube were removed after respiration, 7 cases failed to extubation because of laryngeal stricture and local recurrence, and the rate of extubation was 89.06% (57/64). Conclusions Partial laryngectomy is worth popularizing in clinic.