喉癌手术方式选择与预后生存状况分析.docVIP

喉癌手术方式选择与预后生存状况分析 　　[摘要] 目的 总结喉癌的手术方式，并分析不同手术方案对患者预后生存状况的影响。 方法 回顾性分析214例喉癌患者的手术方案与预后生存状况。 结果 44例未接受气管切开患者的术后喉功能表现明显好于170例切管切开患者。本组患者术后2年生存率为93.0%，3年生存率为89.3%，不同手术类型患者的预后生存率比较差异无统计学意义（P0.05）。手术后发生喉腔肿瘤复发率为7.0%；发生颈部肿瘤复率为7.5%，全喉切除术患者的复发率明显高于其他保留喉功能手术患者，差异有统计学意义（P0.05）。结论 喉癌患者手术方案拟定时需根据其病情程度给予准确评估，在确保肿瘤组织完整切除的基础上尽量采用保留喉功能手术方式。 　　[关键词] 喉癌；手术；预后生存；保留喉功能 　　[中图分类号] R739.65 [文献标识码] B [文章编号] 1673-9701（2015）26-0056-03 　　Analysis of surgical approach and survival status in laryngeal cancer 　　LI Lifang 　　Department of Otolaryngology-Head and Neck Surgery， Central Hospital of Shaoyang City in Hu’nan Province， Shaoyang 422000， China 　　[Abstract] Objective To summarize the surgical approach of laryngeal cancer and analyze the survival status of patients with different surgery. Methods The surgical approach and survival status of two hundred and fourteen patients were analyzed retrospectively. Results After surgery， the laryngeal function of 44 patients whom did not receive tracheotomy were better than 170 patients with tracheotomy. In all patients， the 2-years survival rate was 93.0%， the 3-years survival rate was 89.3%. There was not statistically significant difference in survival rate in patients with different types of surgery （P0.05）. After surgery， the larynx tumor recurrence rate was 7.0%. The neck tumor recurrence rate was 7.5%， the patients with total laryngectomy were significantly higher than patients with laryngeal function sparing surgery（P0.05）. Conclusion Patients with laryngeal cancer need to give accurate assessment of the program according to their severity of disease. To choose the laryngeal function sparing surgery on the basis of tumor tissue removal completely. 　　[Key words] Laryngeal cancer； Surgery； Survival status； Preservation of laryngeal function 　　喉癌主要指以喉部为原发部位的恶性肿瘤疾病，患者常出现咳嗽、声嘶、呼吸障碍及吞咽困难等症状表现，而吸烟、饮酒以及环境恶化等因素是疾病的主要诱发原因[1]。目前，手术方式仍为喉癌患者的有效治疗手段，伴随临床医疗技术的不断进步，其外科手术已由传统的根治方式逐渐转向微创或保留喉功能等术式[2]。临床医师在早期诊断后给予适合手术方案，一方面确保肿瘤组织完整切除，促进良好预后生存状况，另一方面避免喉部组织严