摘要:
Objective To study the effects of two kinds of vertical partial laryngectomy on laryngeal function,postoperative extubation rate and survival rate of patients with glottic laryngeal carcinoma.Methods From January 2013 to January 2014,one hundred and fifty patients with glottic carcinoma who treated in Huzhou Gospel Hospital were selected.The patients were divided into observation group and control group by random number table method,with 75 cases in each group.The control group used the traditional vertical partial laryngectomy,the observation group was treated with modified vertical partial laryngectomy.The postoperative survival rate,extubation rate,extubation time and complications were observed in the two groups.Results The extubation rate was 100.00% (75/75) in the observation group and 97.33% (73/75) in the control group,the difference was statistically significant between the two groups(χ2 =2.027,P>0.05).The extubation time in the observation group was (11.85 ± 0.49)d,which in the control group was (14.55 ± 0.56) d,the difference was statistically significant between the two groups( t=31.424, P0.05).The 3-year survival rate of the observation group was 97.33% (73/75),which of the control group was only 88.00% (66/75),the differ-ence was statistically significant between the two groups (χ2 =4.807,P0.05).Conclusion Improved vertical hemilaryngectomy therapy for patients with glottic laryngeal carcinoma can effectively shorten the time of extubation,better preserve swallowing function,improve the long-term survival rate,and the extubation rate and complication rate are similar with the traditional vertical partial laryngectomy.%目的 研究两种垂直部分喉切除术对声门型喉癌患者喉部功能、术后拔管率及生存率的影响.方法 选择湖州市福音医院2013年1月至2014年1月治疗的声门型喉癌患者150例,采用随机数字表法分为观察组75例和对照组75例.对照组应用传统垂直部分喉切除术,观察组采用改良垂直半喉切除术.观察两组患者的术后生存率、拔管率、拔管时间及并发症发生情况等.结果 观察组拔管率为100.00% (75/75),对照组拔管率为97.33% (73/75),差异无统计学意义(χ2 =2.027,P>0.05);观察组拔管时间为(11.85 ± 0.49)d,对照组拔管时间为(14.55 ± 0.56)d,差异有统计学意义(t=31.424,P0.05),观察组患者术后3年的生存率为97.33% (73/75),对照组为88.00% (66/75)(χ2 =4.807,P<0.05).两组患者均未出现咽瘘,对照组出现5例切口感染,观察组出现1例切口感染,两组患者并发症发生率差异无统计学意义( χ2 =2.778,P=0.096).结论 改良垂直半喉切除术治疗声门型喉癌患者能有效缩短拔管时间,较好地保存患者喉部吞咽功能,提高3年生存率,但拔管率、并发症发生率与传统垂直部分喉切除术并无明显差异.