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    全喉切除术和喉部分切除术治疗中晚期喉癌的效果分析

    Analysis of the Effect of Total Laryngectomy and Partial Laryngectomy for Advanced Laryngeal Cancer

    • 摘要: 目的 比较全喉切除术和喉部分切除术治疗中晚期喉癌的效果。方法 回顾性分析78例中晚期喉癌患者的资料,将患者分为喉部分切除组和全喉切除组,其中喉部分切除组有42人,全喉切除组有36人。通过翻阅病例资料、门诊复查、电话随访,比较两组患者的生存率、复发率和喉功能恢复情况。 所有患者术后以华盛顿大学生存质量表(UW-QOL)为评分标准进行问卷调查,评估患者的生存质量。结果 喉部分切除组患者的1、3年生存率分别为90.48%、76.19%,全喉切除组的1、3年生存率分别为94.44%、77.78%,差异无统计学意义(P>0.05)。喉部分切除组患者的1、3年肿瘤复发率为19.05%、33.33%,全喉切除组的1、3年肿瘤复发率为8.33%、22.22%,两组复发率差异无统计学意义(P>0.05)。喉部分切除术组的生存质量评分在外貌、工作、言语交流上高于全喉切除组(P<0.05),总分显著高于全喉切除组(P<0.01)。结论 喉部分切除术治疗中晚期喉癌可以提高患者的生存质量,3年生存率与行全喉切除术者无差异,喉癌术后患者容易复发,应注意定期复查,及时行手术治疗复发肿瘤。

       

      Abstract: Objective To compare the clinical effects of total laryngectomy and partial laryngectomy in the treatment of advanced laryngeal cancer. Methods The clinical data of 78 patients with advanced laryngeal carcinoma were retrospectively analyzed. The patients were divided into the partial laryngectomy group and the total laryngectomy group, including 42 in the partial laryngectomy group and 36 in the total laryngectomy group. The survival rate, recurrence rate and laryngeal function recovery of the two groups were compared by reading case data, outpatient review and telephone follow-up. The quality of life of the patients was assessed by the University of Washington Quality of life questionnaire (UW-QOL). Results The 1 and 3 year survival rates of the partial laryngectomy group were 90.48% and 76.19% ,the 1 and 3 year survival rates of the total laryngectomy group were 94.44% and 77.78% ,and there was no significant difference between the two groups (P > 0.05). 1 and 3 year tumor recurrence rate of partial laryngectomy group were 19.05% and 33.33%, that of the total laryngectomy group were 8.33% and 22.22%, and there was no significant difference between the two groups (P > 0.05). The quality of life scores of the partial laryngectomy group were higher than those of the total laryngectomy group in appearance, work and verbal communication , and the total score was significantly higher than that of the total laryngectomy group (P < 0.01). Conclusions Partial laryngectomy can improve the quality of life of patients with advanced laryngeal cancer,the 3 year survival rate is not different from that of patients undergoing total laryngectomy, and the recurrence of laryngeal cancer is easy to recur, so regular review should be taken and timely surgical treatment of recurrent tumor should be performed

       

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