全厚皮片在声门型喉癌切除术中的应用

付玉贵; 孙德重; 杨佩珍; 陈彦林; 陈志鹏; 杨兆科

doi:10.13201/j.issn.1001-1781.2016.15.012

全厚皮片在声门型喉癌切除术中的应用

- 临沂市人民医院耳鼻咽喉科(山东临沂, 276000)

详细信息

通讯作者: 付玉贵,E-mail:fuyg163@163.com

中图分类号: R739.65

收稿日期: 2016-03-30

The application of full-thicknes skin graft inpartial laryngectomy for glottic carcinoma

- Department of Otorhinolaryngology, Linyi People's Hospital, Linyi, 276000, China

More Information

Corresponding author: FU Yugui, E-mail: fuyg163@163.com

Received Date: 30 March 2016

摘要

摘要: 目的: 探讨全厚皮片在声门型喉癌切除术中使用的经验及优点。方法: 对143例声门型喉癌患者行喉部分切除术,其中78例(全厚皮片组)应用胸骨舌骨肌筋膜及游离全厚皮片修复喉腔黏膜缺损,65例(肌筋膜组)术中单纯应用胸骨舌骨肌筋膜修复,对2组术后气管套管拔管时间及喉腔肉芽生长情况进行对比。结果: 全厚皮片组术后平均拔管时间6.8 d;有肉芽生长5例,无肉芽生长73例;肌筋膜组术后平均拔管时间10.7 d;有肉芽生长16例,无肉芽生长49例。经过统计学分析,2组患者术后拔管时间差异有统计学意义(t=-4.739,P<0.01),术后喉腔肉芽生长差异亦有统计学意义(χ²=9.379,P<0.01)。全部患者均能顺利拔管,无明显喉狭窄者。结论: 在声门型喉癌患者行喉部分切除术中,应用全厚皮片能缩短拔管时间,并能显著减少喉腔肉芽的生长。
- 喉肿瘤 /
- 喉切除术 /
- 喉功能重建术
Abstract: Objective: The aim of this study is to explore the experience and advantages of the application of full-thicknes skin graft in glottic carcinoma. partial laryngectomy for glottic carcinoma.Method: One hundred and forty-three patients with glottic cancer were treated with partial laryngectomy. Among those,78 cases were repaired with full-thickness skin graft and 65 cases were repaired with sternohyoid muscular fasciae. Compared the time of extubation and the formation of granulation in laryngeal cavity after operation between the two groups.Result: In the group of full-thickness skin graft, the mean time of decannulation was 6.8 days, 5 cases with growth of granulation after operation. In other group, the mean time of decannulation was 10.7 days, 16 cases with growth of granulation after operation.The mean time of decannulation(t=-4.739,P<0.01)and the growth of granulation(χ²=9.379,P<0.01)are significantly different between the two groups. No laryngostenosis was found in all patients.Conclusion: The application of full-thicknes skin graft in partial laryngectomy for glottic carcinoma. can shortthe time of extubation and reduce the formation of granulation.
- laryngeal neoplasms /
- laryngectomy /
- larynx reconstruction

HTML全文

参考文献(8)

[1]	ANDRADES P,PEHLER S F,BARANANO C F,et al.Fistula analysis after radial forearm free flap reconstruction of hypopharyngeal defects[J].Laryngoscope,2008,118:1157-1163.
[2]	邓毅,吴元庆,初亭,等.颈阔肌肌皮瓣在喉成形术中的应用体会[J].中国耳鼻咽喉颅底外科杂志,2006,12(5):398-404.
[3]	裘世杰,黄琦,叶栋,等.胸大肌肌皮瓣在放疗后喉癌及喉咽癌术后咽瘘中的应用[J].中国耳鼻咽喉头颈外科,2015,22(1):10-13.
[4]	邓毅,陈尔东,吴元庆,等.喉气管狭窄T形管扩张术的临床应用和分析[J].中国耳鼻咽喉颅底外科杂志,2015,21(1):69-70.
[5]	钱丽芳,方勤,胥伟华,等.防止喉部前连合手术后粘连的动物实验研究[J].临床耳鼻咽喉头颈外科杂志,2011,25(6):557-559.
[6]	杨柳,杨凤娟,李文,等.异种脱细胞基质修复膜在头颈肿瘤切除术中的应用体会[J].中华耳鼻咽喉头颈外科杂志,2015,50(7):579-582.
[7]	WANG L,LI L,LOU W.Repair of a cervical skin defect using xenogeneic acellular dermal matrix in a patient with advanced laryngeal carcinoma[J].J Laryngol Otol,2015,129:715-717.
[8]	吴旋,苏振忠,蒋爱云,等.喉部分切除术后喉狭窄的相关关因素分析[J].中华耳鼻咽喉头颈外科杂志,2005,40(12):929-932.