中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
33期
1-4
,共4页
喉肿瘤%喉部分切除术%甲状软骨
喉腫瘤%喉部分切除術%甲狀軟骨
후종류%후부분절제술%갑상연골
Laryngeal neoplasms%Partial laryngectomy%Thyroid cartilage
目的 探讨保留甲状软骨的喉部分切除术在治疗声门型喉癌中的可行性及其手术效果.方法 回顾性分析1999年1月至2009年1月收治的声门型喉癌患者128例,术中肉眼和病理证实甲状软骨内膜无癌细胞侵犯或甲状软骨局灶性破坏无需大范围切除的T2-3期病例,采用病例对照研究方法,按部位相同、TNM分期相同,年龄相差≤10岁,1∶1配对.研究组为保留甲状软骨的喉部分切除术患者,共64例,其中T2N038例,T2N16例,T2N21例,T3N0 17例,T3N12例;对照组为传统喉部分切除术患者,共64例,TNM分期同研究组.比较两组患者生存率、局部控制率和总拔管率.结果 研究组3年及5年累积生存率分别为89.8％,84.3％,对照组分别为91.5％,85.4％,两组比较差异无统计学意义(x2=1.687,P＞0.05);研究组局部控制率为91.7％(55/60),对照组为93.2％(55/59),两组比较差异无统计学意义(x2=0.103,P＞ 0.05);研究组总拔管率为98.3％(59/60),对照组为89.8％(53/59),两组比较差异有统计学意义(x2=4.933,P＜ 0.05).结论 对于T2期和部分T3期声门型喉癌患者的治疗,与传统喉部分切除术式相比,保留甲状软骨的喉部分切除术在保证彻底切除肿瘤、保留足够安全缘的同时,保留了喉功能,其术后拔管率高,并发症发生率低,有助于改善喉癌患者术后的生活质量.
目的 探討保留甲狀軟骨的喉部分切除術在治療聲門型喉癌中的可行性及其手術效果.方法 迴顧性分析1999年1月至2009年1月收治的聲門型喉癌患者128例,術中肉眼和病理證實甲狀軟骨內膜無癌細胞侵犯或甲狀軟骨跼竈性破壞無需大範圍切除的T2-3期病例,採用病例對照研究方法,按部位相同、TNM分期相同,年齡相差≤10歲,1∶1配對.研究組為保留甲狀軟骨的喉部分切除術患者,共64例,其中T2N038例,T2N16例,T2N21例,T3N0 17例,T3N12例;對照組為傳統喉部分切除術患者,共64例,TNM分期同研究組.比較兩組患者生存率、跼部控製率和總拔管率.結果 研究組3年及5年纍積生存率分彆為89.8％,84.3％,對照組分彆為91.5％,85.4％,兩組比較差異無統計學意義(x2=1.687,P＞0.05);研究組跼部控製率為91.7％(55/60),對照組為93.2％(55/59),兩組比較差異無統計學意義(x2=0.103,P＞ 0.05);研究組總拔管率為98.3％(59/60),對照組為89.8％(53/59),兩組比較差異有統計學意義(x2=4.933,P＜ 0.05).結論 對于T2期和部分T3期聲門型喉癌患者的治療,與傳統喉部分切除術式相比,保留甲狀軟骨的喉部分切除術在保證徹底切除腫瘤、保留足夠安全緣的同時,保留瞭喉功能,其術後拔管率高,併髮癥髮生率低,有助于改善喉癌患者術後的生活質量.
목적 탐토보류갑상연골적후부분절제술재치료성문형후암중적가행성급기수술효과.방법 회고성분석1999년1월지2009년1월수치적성문형후암환자128례,술중육안화병리증실갑상연골내막무암세포침범혹갑상연골국조성파배무수대범위절제적T2-3기병례,채용병례대조연구방법,안부위상동、TNM분기상동,년령상차≤10세,1∶1배대.연구조위보류갑상연골적후부분절제술환자,공64례,기중T2N038례,T2N16례,T2N21례,T3N0 17례,T3N12례;대조조위전통후부분절제술환자,공64례,TNM분기동연구조.비교량조환자생존솔、국부공제솔화총발관솔.결과 연구조3년급5년루적생존솔분별위89.8％,84.3％,대조조분별위91.5％,85.4％,량조비교차이무통계학의의(x2=1.687,P＞0.05);연구조국부공제솔위91.7％(55/60),대조조위93.2％(55/59),량조비교차이무통계학의의(x2=0.103,P＞ 0.05);연구조총발관솔위98.3％(59/60),대조조위89.8％(53/59),량조비교차이유통계학의의(x2=4.933,P＜ 0.05).결론 대우T2기화부분T3기성문형후암환자적치료,여전통후부분절제술식상비,보류갑상연골적후부분절제술재보증철저절제종류、보류족구안전연적동시,보류료후공능,기술후발관솔고,병발증발생솔저,유조우개선후암환자술후적생활질량.
Objective To compare and evaluate the oncological and functional outcomes between reserving thyroid partial laryngectomy and traditional partial laryngectomy for the treatment of stage T2-3glottic laryngeal carcinoma.Methods One hundred and twenty-eight patients treated from January 1999 to January 2009 were selected from all glottic laryngeal carcinoma patients with stage T2-3,who underwent surgery combined with radiation therapy.A retrospective review was randomized and matched by tumour subsite,TNM stage and age,which were confirmed by pathology and observation without thyroid perichondrium invaded or only local invasion of thyroid cartilage,there was no need to extensively resect laryngeal cartilages.Patients were divided into reserving thyroid partial laryngectomy group(study group) and traditional partial laryngectomy group (control group).Each group included 64 cases,which included T2N0 38 cases,T2N1 6 cases,T2N2 1 case,T3N0 17 cases,T3N1 2 cases.Local control rate,decannulation rate,the 3-year and 5-year accumulative survival rate were compared between two groups.Results The 3-year and 5-year accumulative survival rate were 89.8％ and 84.3％ in study group,91.5％ and 85.4％ in control group,there was no sognificant difference (x2 =1.687,P ＞ 0.05).The local control rate was 91.7 ％ (55/60) in study group and 93.2 ％(55/59) in control group,there was no significant difference (x2 =0.103,P ＞0.05).The decannulation rate was 98.3％ (59/60) in study group and 89.8％(53/59) in control group,there was significant difference (x2 =4.933,P ＜0.05).Conclusions Comparing with traditional partial laryngectomy,reserving thyroid partial laryngectomy is successful for treating properly selected stage T2-3 glottic laryngeal carcinoma.This operation has higher decannulation rate and lower complication,which is effective for reducing surgical invasion and facilitated the resumption of respiratory.
