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目的:评价脱细胞真皮基质（acellular dermal matrix，ADM）联合颈前带状肌（cervical strap muscle，CSM）复合组织瓣在修复喉癌切除后喉腔缺损的临床疗效。方法:回顾性分析中山大学附属第一医院耳鼻咽喉科医院2014年1月至2016年12月采用CSM行喉部分切除术治疗的33例喉癌患者的病例资料，其中男32例，女1例，年龄39~76岁。33例中行ADM-CSM复合组织瓣修复喉腔缺损的患者14例（ADM-CSM组），其中2例为声门上型喉癌，12例为声门型喉癌；行CSM筋膜瓣修复喉腔缺损的患者19例（CSM组），其中3例为声门上型喉癌，16例为声门型喉癌。Kaplan-Meier法统计术后3年生存率曲线和局部控制率曲线。使用嗓音障碍指数-30和MD Anderson吞咽障碍量表评价术后嗓音和吞咽功能情况。不同变量间比较用n t检验、Mann-Whitney n U检验和单因素逻辑回归分析。n 结果:ADM-CSM组和CSM组喉狭窄的发生率分别为2/14和4/19。ADM-CSM组的3年总体生存率和局部控制率分别为92.9%和85.7%。CSM组的3年生存率和局部控制率分别为78.9%和84.2%。ADM-CSM组与CSM组比较，手术时间（3 h比4 h，n Z=193.5，n P<0.05）、留置胃管时间（14 d比17 d，n Z=206.0，n P<0.05）和住院天数（18.5 d比22.1 d，n t=-2.62，n P<0.05）均少于CSM组，差异有统计学意义。CSM组患者术后嗓音功能优于ADM-CSM组[（66.85±27.65）分比（45.80±23.19）分，n t=2.19，n P<0.05]，而ADM-CSM组的患者术后吞咽功能优于CSM组（80.00[60.00, 80.00]分比60.00[40.00, 80.00]分，n Z=48.0，n P<0.05）。n 结论:ADM-CSM复合组织瓣修复喉癌术后喉腔缺损操作简便，安全性高，术后瘢痕组织增生减少，患者吞咽功能满意度高。“,”Objective:To investigate the clinical efficacy of acellular dermis matrix combined with cervical strap muscle (ADM-CSM) as a composite tissue flap for repairing the laryngeal defect after partial laryngectomy.Methods:The medical records of 33 patients with laryngeal cancer who were diagnosed and treated at the First Affiliated Hospital of Sun Yat-sen University from January 2014 to December 2016 were retrospectively reviewed. The patients consisted of 32 males and 1 female with age range from 39 to 76 years. Laryngeal defects were repaired with ADM-CSM in 14 patients (2 for supraglottic laryngeal cancer, 12 for glottic laryngeal cancer) and with CSM fascial flaps in 19 patients (3 for supraglottic laryngeal cancer, 16 for glottic laryngeal cancer). Kaplan-Meier method was used to calculate the 3-year overall survival and local control rate. The functions of voice and swallowing after operation were evaluated by voice handicap index-30 (VHI-30) and MD Anderson dysphagia inventory. Univariate logistic regression analysis, n t-test, and Mann-Whitney n U test were used to compare the variables between the two groups.n Results:The incidence of laryngeal stenosis was 2/14 in ADM-CSM group and 4/19 in CSM group. In the ADM-CSM group, 3-year overall survival and local control rates were 92.9% and 85.7%, respectively. In the CSM group, 3-year overall survival and local control rates were 78.9% and 84.2%, respectively. The time of operation(3 h n vs. 4 h, n Z=193.5, n P<0.05), time of retaining the feeding tube(14 dn vs. 17 d, n Z=206.0, n P<0.05), and length of stay(18.5 dn vs. 22.1 d, n t=-2.62, n P<0.05) in the ADM-CSM group were significantly less than those in the CSM group. The quality of voice in the CSM group was better than that in the ADM-CSM group (66.85±27.65n vs.45.80±23.19, n t=2.19, n P<0.05), while swallowing function in the ADM-CSM group was better than that in the ACSM group (80.00[60.00, 80.00]n vs.60.00[40.00, 80.00], n Z=48.0, n P<0.05).n Conclusion:ADM-CSM is user-friendly control and safe composite tissue flap for repairing the laryngeal defect after partial laryngectomy, with less scar hyperplasia and higher satisfaction of swallowing function after operation.