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目的 探讨声门上喉癌手术治疗的方法及其疗效。方法 对 182例声门上喉癌患者进行手术治疗。按 1997年UICC修订案分期 ,Ⅰ期 11例 ,Ⅱ期 45例 ,Ⅲ期 49例 ,Ⅳ期 77例。根据病变情况不同 ,采用相应的切除及修复方式。结果 全组喉部分切除术占 78.6 % (143/ 182 ) ;Ⅲ、Ⅳ期患者中 ,喉部分切除术占 6 9.8% (88/ 12 6 )。喉部分切除术拔管率为 81.8% (117/ 143)。全组患者 3,5年生存率分别为 82 .9%和 6 7.3% ,Ⅲ、Ⅳ期喉部分切除术患者的 3,5年生存率分别为 76 .9%和 5 7.4% ,Ⅲ、Ⅳ期全喉切除术患者的 3,5年生存率分别为 82 .5 %和 6 7.0 %。Ⅲ、Ⅳ期喉部分切除术与全喉切除术患者的生存率差异无显著性 (P >0 .0 5 )。结论 晚期声门上喉癌保留喉功能是可行的。熟练掌握多种修复方法 ,择优采用 ,可提高喉功能的保留率。
Objective To investigate the surgical treatment of supraglottic carcinoma and its curative effect. Methods 182 patients with supraglottic laryngeal cancer were treated surgically. According to 1997 UICC revised staging, stage Ⅰ in 11 cases, stage Ⅱ 45 cases, stage Ⅲ 49 cases, stage Ⅳ 77 cases. According to the different lesions, using the appropriate removal and repair methods. Results The total laryngectomy accounted for 78.6% (143 of 182 cases). Among the patients of stage Ⅲ and Ⅳ, partial laryngectomy accounted for 68.8% (88/126). Laryngectomy extubation rate was 81.8% (117/143). The 3- and 5-year overall survival rates were 82.9% and 63.3% in the whole group, respectively. The 3 and 5-year survival rates of stage III and IV laryngectomy were 76.9% and 5 7.4% The 3 and 5-year survival rates of patients undergoing total laryngectomy were 82.5% and 6 7.0%, respectively. There was no significant difference in the survival rates between stage Ⅲ and stage Ⅳ laryngectomy and total laryngectomy (P> 0.05). Conclusion Late laryngeal cancer of larynx preserves laryngeal function is feasible. Proficiency in a variety of repair methods, preferential use, can improve the retention rate of laryngeal function.