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目的探讨不同手术方案对喉癌和下咽癌患者保留喉功能的疗效。方法 80例喉癌和下咽癌患者按照随机数字表法分为观察组和对照组,每组40例,观察组患者实施简易气管造瘘术,对照组患者采用气管切开术。对比两组患者的术后换管效果、并发症和生活质量。结果观察组患者更换套管时可以通过牵引拉开双侧留置的缝合线,造瘘口相对较为宽大,与对照组相比,换管迅速,术后6个月两组均无带管患者。观察组患者的并发症发生率为5.0%,显著低于对照组的25.0%,差异均有统计学意义(均P<0.05)。观察组患者的总体健康、生理职能、生理功能、躯体疼痛、社会功能、活力、精神健康和情感职能8个维度的生活质量量表评分均显著高于对照组,差异有统计学意义(P<0.05)。结论与气管切开术相比,简易气管造瘘术能够显著降低换管时间和并发症发生率,提升患者的生活质量。
Objective To investigate the effect of different surgical regimens on preserving laryngeal function in patients with laryngeal and hypopharyngeal carcinoma. Methods 80 cases of laryngeal cancer and hypopharyngeal cancer patients were divided into observation group and control group according to random number table method, 40 cases in each group. The observation group was treated with simple tracheostomy and the control group with tracheotomy. The postoperative management results, complications and quality of life of the two groups were compared. Results In the observation group, when the cannula was replaced, it was possible to stretch the bilateral suture by traction, and the fistula was relatively wide. Compared with the control group, the tube was changed rapidly. There was no catheterized patients in both groups at 6 months after operation. The incidence of complication in the observation group was 5.0%, which was significantly lower than that in the control group (25.0%) (all P <0.05). The scores of quality of life scale in 8 dimensions of overall health, physiology, physiology, body pain, social function, vitality, mental health and emotional function in observation group were significantly higher than those in control group (P < 0.05). Conclusions Compared with tracheotomy, simple tracheostomy can significantly reduce the time and complications of tube replacement and improve the quality of life of patients.