河南科技大学学报（医学版）
河南科技大學學報（醫學版）
하남과기대학학보（의학판）
JOURNAL OF HENAN UNIVERSITY OF SCIENCE & TECHNOLOGY(MEDICAL SCIENCE)
2015年
2期
100-104
,共5页
漫一凡%张超%周延辉%李怡楠
漫一凡%張超%週延輝%李怡楠
만일범%장초%주연휘%리이남
声门型喉癌%硅胶膜%喉裂开术%喉功能
聲門型喉癌%硅膠膜%喉裂開術%喉功能
성문형후암%규효막%후렬개술%후공능
glottic laryngeal cancer%silica membrane%laryngofissure%laryngeal function
目的：分析 T 形与 V 形喉硅胶膜在早期声门型喉癌喉裂开术后的应用价值。方法收集2012年7月至2015年3月我院收治的早期声门型喉癌（T1～T2期）行喉裂开病变切除术共60例，34例术后放置 T 形硅胶膜，26例放置 V 形喉硅胶膜。对比两组患者术后的疼痛程度、呼吸功能、发音功能、吞咽功能及黏膜的恢复等情况。结果两组患者术后疼痛程度（NRS）评分比较，差异有统计学意义（P ＜0．05）。两组在胃管拔除时间上 T 形膜组时间长于 V 形膜组（P ＜0．05）。T 形膜组发音质量（VHI）与 V 形组相比差异有统计学意义（21．13±6．10 Vs 18．36±7．28，P ＜0．05），嗓音总嘶哑度评估中，两组大部分为轻中度异常，差异有统计学意义（82．35％ Vs 96．15％，P ＜0．05）。结论本研究显示喉硅胶膜置入能有效避免声门型喉癌喉裂开术后瘢痕形成而引起喉狭窄，V 形硅胶膜则是从声门正常的结构考虑能更有效恢复患者的嗓音学状态，术后痛苦小、恢复快、并发症少，术后喉功能保全良好，提高了患者的生存质量。
目的：分析 T 形與 V 形喉硅膠膜在早期聲門型喉癌喉裂開術後的應用價值。方法收集2012年7月至2015年3月我院收治的早期聲門型喉癌（T1～T2期）行喉裂開病變切除術共60例，34例術後放置 T 形硅膠膜，26例放置 V 形喉硅膠膜。對比兩組患者術後的疼痛程度、呼吸功能、髮音功能、吞嚥功能及黏膜的恢複等情況。結果兩組患者術後疼痛程度（NRS）評分比較，差異有統計學意義（P ＜0．05）。兩組在胃管拔除時間上 T 形膜組時間長于 V 形膜組（P ＜0．05）。T 形膜組髮音質量（VHI）與 V 形組相比差異有統計學意義（21．13±6．10 Vs 18．36±7．28，P ＜0．05），嗓音總嘶啞度評估中，兩組大部分為輕中度異常，差異有統計學意義（82．35％ Vs 96．15％，P ＜0．05）。結論本研究顯示喉硅膠膜置入能有效避免聲門型喉癌喉裂開術後瘢痕形成而引起喉狹窄，V 形硅膠膜則是從聲門正常的結構攷慮能更有效恢複患者的嗓音學狀態，術後痛苦小、恢複快、併髮癥少，術後喉功能保全良好，提高瞭患者的生存質量。
목적：분석 T 형여 V 형후규효막재조기성문형후암후렬개술후적응용개치。방법수집2012년7월지2015년3월아원수치적조기성문형후암（T1～T2기）행후렬개병변절제술공60례，34례술후방치 T 형규효막，26례방치 V 형후규효막。대비량조환자술후적동통정도、호흡공능、발음공능、탄인공능급점막적회복등정황。결과량조환자술후동통정도（NRS）평분비교，차이유통계학의의（P ＜0．05）。량조재위관발제시간상 T 형막조시간장우 V 형막조（P ＜0．05）。T 형막조발음질량（VHI）여 V 형조상비차이유통계학의의（21．13±6．10 Vs 18．36±7．28，P ＜0．05），상음총시아도평고중，량조대부분위경중도이상，차이유통계학의의（82．35％ Vs 96．15％，P ＜0．05）。결론본연구현시후규효막치입능유효피면성문형후암후렬개술후반흔형성이인기후협착，V 형규효막칙시종성문정상적결구고필능경유효회복환자적상음학상태，술후통고소、회복쾌、병발증소，술후후공능보전량호，제고료환자적생존질량。
Objective To investigate the applicational value and curative effect between T-shaped silicone membrane and V-shaped silicone membrane in early glottic laryngeal cancer after laryngofissure cardectomy. Methods 60 patients with early glottic laryngeal cancer on T1 ~T2 stage from July 2012 to March 2015 treated in our hospital were included.All the patients accepted the laryngofissure cordectomy,in which 34 patients were placed T-shaped silicone membrane and 26 patients were placed V-shaped silicone membrane.After operation we analysed the differences on pain degree,respiratory function,phonation, swallowing function and mucosa recovery between the two groups of patients. Results Comparing postoperative pain degree via using numeric rating scales (NRS),the differences between the two groups had statistical significance (P <0.05).In gastric tube removed time,the T-shaped silicone membrane group was longer than that of the V-shaped silicone membrane group,and the differences between the two groups had statistical significance (P <0.05).Compared phonation function,the mean of Voice Handicap Index (VHI) in the T-shaped silicone membrane group and the V-shaped silicone membrane group had statistical significance (21.13 ±6.10 Vs 18.36 ±7.28,P < 0.05 ).Most patients in both groups were mild-to-moderate abnormal degree when compare the index of total hoarse voice degree G score,and difference between two groups on total hoarse voice degree G score was statistically significant (P <0.05).Conclusion Our results prove that silica gel membrane implantation can significantly avoid laryngeal stenosis due to the scarring after bilateral vocal cord lesions resection.The V-shaped silicon membrane from the structure of the glottis normal consider state can effectively restore the patient′s voice,mild postoperative pain,rapid recovery,fewer complica-tions,and has a lot to improve on the postoperative laryngeal function preservation and the quality of life of patients.
