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目的 :评价垂直部分喉切除术治疗喉癌的效果。方法 :1979～ 1990年行手术加放疗 2 4例 ,单纯手术 1例 ;1991～ 1997年行单纯手术治疗 2 2例 ,术后放疗 3例。新声门重建采用甲状软骨外软骨膜修复 2 2例 ,单蒂胸骨舌骨肌修复 14例 ,创面直接对合重建声带 10例 ,游离皮片移植 2例 ,颈前皮瓣修复 1例 ,舌骨肌瓣修复 1例。结果 :拔管率为 98.0 % (47/ 4 8) ,有良好的发声和吞咽功能 ;3、5、10年生存率分别为 89.6 %、82 .9%、6 6 .7% ;局部复发死亡 4例 ,死于远处转移 1例 ,死于食管癌 1例 ,非肿瘤死亡 5例。结论 :垂直部分喉切除术是治疗喉癌的有效术式 ,麻醉方式、手术切除范围和修复方法的合理选择可进一步提高疗效
Objective: To evaluate the effect of vertical partial laryngectomy in the treatment of laryngeal cancer. Methods: Between 1979 and 1990, 24 cases were treated by surgery and radiotherapy, and 1 case was treated by simple operation. Between 1991 and 1997, 22 cases were treated by simple operation and 3 cases were treated by postoperative radiotherapy. Reconstruction of the new glioma with cartilage repair of thyroid cartilage in 22 cases, monosial sternal repair of the hyoid muscle in 14 cases, the wound directly to the reconstruction of vocal cord in 10 cases, 2 cases of free skin graft, anterior cervical flap repair in 1 case, tongue Bone muscle flap repair in 1 case. Results: The rate of extubation was 98.0% (47/48), with good vocalization and swallowing function. The survival rates at 3, 5 and 10 years were 89.6%, 82.9% and 66.7% respectively. The local recurrence and death 4 cases died of distant metastasis in 1 case, died of esophageal cancer in 1 case, non-tumor death in 5 cases. CONCLUSION: Vertical partial laryngectomy is an effective procedure for the treatment of laryngeal cancer. The reasonable choice of anesthesia mode, surgical resection scope and repair method can further improve the curative effect