CAJ | 학술논문

目的评价Amatsu法发音蕈建术的临床效果.方法 60例喉全切除、双颈淋巴清扫术患者一期行Amatsu法发音重建术,其中喉癌49例,下咽癌11例;1例术前放疗80 Gy,20例术后放疗60～70 Gy.术后随访3～6年,评价言语、吞咽功能.结果 52例(86.7%)术后均获得良好的言语功能,其中吞咽功能正常51例,另1例进食流食时可见气管内少量滴漏.8例(11.3%)发音重建失败,吞咽功能均正常:4例因并发咽瘘(其中术前放疗1例),经换药、抗感染处理后咽瘘均痊愈,吞咽功能正常,但已敛发音管坏死,发音失败;2例因气管食管造口粘连致发音管闭锁,未再行补救性手术,改用人工喉发音;1例不明原因呼吸困难;1例无发音意愿.20例术后放疗者言语功能有暂时性影响,均恢复良好.结论 Amatsu法发音重建术可一期重建喉全切除患者的言语和吞咽功能,可获得良好的发音效果,术后放疗不影响患者的远期发音效果.
목적 평개Amatsu법발음심건술적림상효과.방법 60례후전절제、쌍경림파청소술환자일기행Amatsu법발음중건술,기중후암49례,하인암11례;1례술전방료80 Gy,20례술후방료60～70 Gy.술후수방3～6년,평개언어、탄인공능.결과 52례(86.7%)술후균획득량호적언어공능,기중탄인공능정상51례,령1례진식류식시가견기관내소량적루.8례(11.3%)발음중건실패,탄인공능균정상:4례인병발인루(기중술전방료1례),경환약、항감염처리후인루균전유,탄인공능정상,단이렴발음관배사,발음실패;2례인기관식관조구점련치발음관폐쇄,미재행보구성수술,개용인공후발음;1례불명원인호흡곤난;1례무발음의원.20례술후방료자언어공능유잠시성영향,균회복량호.결론 Amatsu법발음중건술가일기중건후전절제환자적언어화탄인공능,가획득량호적발음효과,술후방료불영향환자적원기발음효과.
Objective To evaluate rehabilitation effect of Amatsu' s tracheoesophageal shunt operation after total laryngectomy with sphincter mechanism. Methods Voice rehabilitations were performed for 60 cases with Amatsu' s tracheoesophgea[shunt operation after total laryngectomy with sphincter mechanism, in which 20 cases were involved in post-operation radiation therapy. Results Fifty two (86.7%) cases developed speech with voice and swallow rehabilitation, but 1 case of them suffered water drip from his tracheoesophageal shunt when drinking. The other 8 (11.3%) cases developed swallow rehabilitation but failed in speech rehabilitation for pharyngeal fistula (4 cases,in which 1 had pre-operative radiation therapy), tracheoesophageal shunt obstruction (2 cases), dyspnea with unknowen reason (1 cases), no desire to speech(1 cases). Furthermore, all the 20 cases who were involved in post-operative radiative therapy restore their speech and swallow capability finally. Conclusions Amatsu's tracheoesophageal shunt operation with sphincter mechanism brought effective speech rehabilitation results for total laryngectomee even with pest-operation radiation therapy.