解除环咽肌失弛缓在发音重建中的临床意义及发音钮瓣膜生物膜的检测.pdfVIP

ABSTRACT Objective In those patients discusses the influence of the negative effect of pharyngoesophageal sphincter on the Groningen prosthesis voice restoration following total laryngectomy and The comparison of the solution,and underst and the voice protheses valve microbial growth situation.Methods the clinical datas that 56 patients with Groningen voice protheses rebuild pronunciation after total laryngectomy were analyzed retrospectively.Compare the success rate of three kinds of operation.Testing valve microbial growth situation after removed he voice protheses.Results The patients with 42 cases succeed,among which success rate of amputating pharynx plexus nerves group is 60.00%,amputating cricopharyngeal muscle group is 62.50%,and at the same time amputating pharynx plexus nerves and amputating cricopharyngeal muscle group is 96.00%. Tested 30 voice protheses,all have microbial growth.Conclusion The success rate of simultaneously amputating pharynx plexus nerves and amputating cricopharyngeal muscle bears higher pronunciation success rate.The life of voice protheses can also be primarily related to candida albicans. Key Words: Laryngeal neoplasms:Total laryngectomy:Pronunciation rebuild :Voice protheses 2 前言 喉癌是头颈部常见的恶性肿瘤，目前其发病率有明显增长趋势。喉 癌的治疗以手术为主，喉全切除术是治疗中晚期喉癌的主要方法。喉全切 术后发音钮发音重建是最常用的发音重建的方式。其中低阻力型Groningen 硅胶发音钮以其阻力低、寿命较长、勿需清理等优点得到临床医师的青睐。 术后咽食管括约肌失弛缓常常导致发音钮发音失败的主要原因之一。我院 自2007年开展低阻力型Groningen硅胶发音钮发音重建术共56例。针对咽食 管括约肌失弛缓造成的无喉患者无法重新发音的难题，在喉全切除术中进 行咽食管括约肌切开术和或咽丛神经分支切断术，提高喉全切术后发音钮 发音重建的成功率。 安装发音钮后，当硅胶发音钮长时间嵌入到气管食管穿刺道内时，其 瓣膜持续接触食管内的有菌的环境，由于瓣膜食管侧持续的接触食物、唾 液及口咽部的多种微生物，致使细菌和真菌组成的