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目的探索用手术方法解除鼻咽癌放疗后放射性脑病相关顽固性吸入性肺炎,提高患者的生存质量和延长生存期。方法用两种术式分别处理2例典型患者,将喉气管分离,堵截食物误入气道的途径,并以颈前气管造口代替佩戴气管套管。结果2例典型患者在手术治疗后,分别随访观察2年和4年,肺部感染在手术后2周治愈,未再次出现吸入性肺部感染,1例恢复部分户外活动,另1例恢复经口进食,2例体质量增加5kg以上,生活质量和心理状态均有明显改善。结论喉-气管分离术能有效防治鼻咽癌放疗后放射性脑病相关顽固性吸入性肺炎,值得临床推广。
Objective To explore the surgical method to relieve nasopharyngeal carcinoma radiotherapy after radiation-induced etiology associated with refractory aspiration pneumonia, improve patient quality of life and prolong survival. Methods Two cases of typical patients were treated with two kinds of surgical procedures, the laryngotracheal tube was separated to intercept food into the airway, and the tracheostomy was replaced by tracheostomy tube. Results Two cases of typical patients were followed up for 2 years and 4 years after operation. Pulmonary infection was cured 2 weeks after operation. Infectious pulmonary infection did not occur again. One case recovered part of outdoor activities and another case recovered. Mouth eating, 2 cases of body weight increased more than 5kg, quality of life and psychological conditions have significantly improved. Conclusion Laryngeal-tracheostomy can effectively prevent and treat radiation-induced encephalopathy-related refractory aspiration pneumonia after nasopharyngeal carcinoma, which is worthy of clinical promotion.