保留后1/4甲状软骨板的喉环上部分切除改良术(1)

                  作者：郝森，郭晓光，艾洁，张世春

【摘要】  目的 通过对传统喉环上部分喉切除术式进行改良，以改善患者术后的吞咽、发音功能，减少误吸，提高术后拔管率。方法 将传统术式进行改良，保留后1/4甲状软骨板以求恢复梨状窝的解剖结构。改良术式10例与传统术式10例随机组成对照组，来对比术后患者误吸程度、发音质量、术后拔管时间进行研究讨论。结果 经治疗比较，传统术式10例患者与改良术式10例患者都于术后10~12天开始经口饮食，传统术式呛咳明显，其中有7例不能正常饮食，且发音质量不理想。而改良术式10例患者可经口正常饮食，且发音质量比传统术式明显改善。结论 保留后1/4甲状软骨板的喉环上部分切除改良术能很好地改善患者术后吞咽、发音功能，减少误吸，提高拔管率。

【关键词】  保留甲状软骨板；梨状窝；误吸

    Modified resection procedure of upper section of larynx of cricoid cartilage by preservation of the post-quarter thyroid cartilage plate

       ［Abstract］  Objective  To improve the traditional resection procedure of upper section of throat laryux of cricoid cartilage resection to improve swallow function and pronunciation function post-operatively，and reduce the wrong draw，and incerease the rate of pulling tubing post-operatively.Methods  To improve traditional resection of preservation of the post-quarter thyroid cartilage plate is reserved to restore the structure of recessus piriformis.The improvement group were 10 patients，the traditional resection group were 10 patients.To compare the two group of the degree of wrong absorb，pronunciation function and the time of pulling tubing post-operation.Results  By comparison,all patients in two groups could eat in 10~12 days.The patients in traditioual resection group ate wit obviously,and 7 cases of them could not have meal normally with dissatisfied pronumciation.In contrast,patients in improvement group could eat normally with pronunciation function improved obviousy.Conclusion  The preservation of the post-quarter thyroid cartilage plate could improve swallow function and helpful to improve pronunciation function，and reduce wrong absorb，and increase the rate of pulling tubing post-operative.

    ［Key words］  preservation thyroid cartilage plate;recessus piriformis；wrong absorb

    随着对喉癌局部扩展规律的不断深入了解，保留喉功能的各种部分 喉切除术越来越普遍应用，对减少各种部分喉的术后并发症及更好的恢复喉功能就成了以后功能保全手术的发展的趋势，我院采用保留后1/4甲状软骨板环上部分切除改良术10例与传统术式10例对照术后患者误吸，呛咳，正常经口饮食时间及拔管时间明显改善，现报告如下。

    1  资料与方法

    1.1  一般资料  保留后1/4甲状软骨板喉环上部分喉改良术10例，其中男9例，女1例，年龄49~69岁。传统术式对照组10例，男8例，女2例，年龄51~78岁。

    1.2  方法  术后观察患者误吸、呛咳程度、正常经口饮食时间、拔管时间及发音质量，两组进行比较。

共2页: 1 [2] 下一页