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目的 评价声门上水平部分喉切除术的手术方法及远期疗效。方法 我科 1 986～1 995年采用声门上水平部分喉切除治疗喉癌声门上型 5 5例 ,男 32例 ,女 2 3例。平均年龄 5 6岁。Ⅰ期 1 1例 ,Ⅱ期 2 6例 ,Ⅲ期 1 1例 ,Ⅳ期 7例。对声门上水平部分喉切除加以改进。用两侧梨状窝内侧壁粘膜缝合 ,封闭甲状软骨断面的后 1 / 3,用甲状软骨外骨膜同喉室底壁粘膜缝合 ,封闭甲状软骨断面的前 2 / 3。切除舌骨 ,将保留的甲状软骨同舌根缝合 ,使舌根起到会厌的作用。结果 3年生存率为 85 % (47/ 5 5 ) ;5年生存率为 77% (37/ 48)。喉功能恢复情况 :拔管率为 96 % ,吞咽功能在 8～ 30d恢复 ,无呛咳。发音功能良好。常见并发症 :舌根及前联合处有肉芽及息肉生长 (4例 )。结论 该术式能彻底切除肿瘤 ,并完全保留喉的生理功能 ,是喉癌外科治疗中理想的部分喉切除术。
Objective To evaluate the surgical methods and long-term efficacy of horizontal partial laryngectomy on the glottis. Methods A total of 55 cases of laryngeal supraglottic carcinoma were treated with supraglottic partial laryngectomy from 1986 to 1995 in our department. There were 32 males and 23 females. The average age of 56 years old. 11 cases were stage Ⅰ, 26 cases were stage Ⅱ, 11 cases were stage Ⅲ, and 7 cases were stage Ⅳ. Improve the level of the larynx on the glottis. The mucosal suture of the inner side of the pear-shaped fossa on both sides was used to seal the posterior thyroid cartilage, and the posterior thyroid cartilage was sutured with the mucosa of the base of the throat to close the first two-thirds of the thyroid cartilage. Excision of the hyoid bone, the thyroid cartilage will be retained with the tongue root suture, the tongue base play a role in epiglottis. Results The 3-year survival rate was 85% (47/55) and the 5-year survival rate was 77% (37/48). Laryngeal function recovery: extubation rate was 96%, swallowing function recovered in 8 ~ 30d, no cough. Pronunciation function is good. Common complications: tongue base and the former joint granulation and polyp growth (4 cases). Conclusion This procedure can completely remove the tumor and completely preserve the physiological functions of the larynx. It is an ideal partial laryngectomy in the surgical treatment of laryngeal cancer.