颈前转门肌蒂皮瓣修复术治疗喉癌术后喉狭窄的临床分析
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Clinical analysis of the repair of anterior cervical rotation portal myocutaneous flap in the treatment of laryngostenosis after laryngeal cancer surgery
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    目的:分析喉癌术后喉狭窄的原因,探讨颈前转门肌蒂皮瓣修复术治疗喉癌术后喉狭窄的临床疗效。方法:回顾性分析2018年1月-2021年10月于我科就诊收住院的39例喉癌术后出现喉狭窄患者的临床资料,其中19例采用颈前转门肌皮瓣修复术,20例采用显微支撑喉镜下CO2激光术,所有患者术后随访1个月~36个月,记录患者的诊疗情况、手术次数、拔管时间。结果:39例喉狭窄患者中,19例行颈前转门肌皮瓣修复术者,一次手术后成功拔管率为78.95%,高于显微支撑喉镜下CO2激光术者一次手术后成功拔管率(50.00%)。在III度、IV度喉狭窄患者的治疗中,两种术式一次术后拔管率有统计学意义(P<0.050)。两种术式在术后拔管时间上的差异存在统计学意义(P<0.050)。在严重喉狭窄的治疗中,颈前转门肌皮瓣修复术较显微支撑喉镜下CO2激光术一次术后拔管率高且再狭窄发生率低。结论:颈前转门肌蒂皮瓣修复术是针对喉癌术后喉狭窄的一种有效的治疗手段。

    Abstract:

    Objective: To review the clinical features of the patients with laryngeal stenosis after laryngeal cancer surgery, and the surgical outcomes of the repair of anterior cervical rotation portal myocutaneous flap in the treatment of laryngeal stenosis.Methods: Between January 2018 and October 2021,39 patients with laryngeal stenosis after laryngeal cancer were retrospectively analyzed. 19 patients underwent the anterior cervical rotation portal myocutaneous flap repair.20 patients underwent CO2 laser surgery under microscopic support laryngoscope.All patients were followed up for 1 month to 36 months after operation.The treatment conditions and extubation time of the patients were recorded. Results: Among the 39 patients with laryngeal stenosis, 19 patients who underwent the repair of anterior cervical rotation portal myocutaneous flap had a successful extubation rate of 78.95% after one operation, which was higher than that of those who underwent CO2 laser surgery under microscopic support laryngoscope(50.00%). In the treatment of patients with laryngeal stenosis,the anterior cervical stenosis myocutaneous flap repair has a higher rate of postoperative extubation and a lower incidence of restenosis than CO2 laser under microscopic support laryngoscopy. Conclusion: The repair of anterior cervical rotation portal myocutaneous flap is an effective treatment for the patients with laryngeal stenosis after laryngeal cancer surgery.

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  • 收稿日期:2022-02-22
  • 最后修改日期:2022-04-27
  • 录用日期:2022-05-06
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