喉功能保留策略中不同治疗方法对中晚期喉癌及下咽癌预后的影响

发布时间：2018-05-25 04:26

本文选题：气管造瘘术 + 气管切开术　；参考：《中国老年学杂志》2017年08期

【摘要】：目的探讨喉功能保留策略中不同治疗方法对中晚期喉癌及下咽癌预后的影响。方法回顾性研究56例晚期喉癌及下咽癌患者的临床资料。根据治疗方案分为保留手术组(22例)、调强放疗组(19例)和同步放化疗组(15例)。保留手术组接受切除病灶和喉功能保留手术治疗,调强放疗组接受靶区直线加速器适型调强放射治疗,同步放化疗组接受与调强放疗相同的放射治疗和化疗。对三组手术后治疗效果、生存质量、不良反应发生情况进行评估。结果保留手术组治疗有效率显著高于同步放化疗组,同步放化疗组显著高于调强放疗组(均P0.05)。保留手术组生理功能、生理职能、情感职能、躯体疼痛、社会功能、精神健康、活力和总体健康等生存质量维度得分均显著高于其余两组,同步放化疗组得分显著高于调强放化疗组(均P0.05)。保留手术组出现咽瘘的患者显著多于其余两组,而出现吞咽困难、语言交流障碍和呼吸障碍的人数显著少于其余两组(均P0.05)。结论在喉功能保留策略中选用喉保留手术,临床疗效显著,同时可以显著提高患者的生存质量,降低术后并发症。
[Abstract]:Objective to investigate the effect of different treatment methods on the prognosis of advanced laryngeal carcinoma and hypopharyngeal carcinoma. Methods the clinical data of 56 patients with advanced laryngeal carcinoma and hypopharyngeal carcinoma were retrospectively studied. According to the treatment plan, 22 patients were divided into two groups, 22 patients in reserved operation group, 19 patients in intensity modulated radiotherapy group (19 patients) and 15 patients in concurrent radiotherapy and chemotherapy group (15 patients). The reserving operation group received resection of lesion and laryngeal function preservation surgery, the intensity modulated radiotherapy group received target linear accelerator intensity modulated radiotherapy, and the synchronous radiotherapy group received the same radiotherapy and chemotherapy as intensity modulated radiotherapy. The effect, quality of life and adverse reaction of the three groups were evaluated. Results the effective rate in the reserving operation group was significantly higher than that in the simultaneous radiotherapy and chemotherapy group, and that in the synchronous radiotherapy group was significantly higher than that in the intensity modulated radiotherapy group (all P 0.05). The scores of physical function, physiological function, emotional function, somatic pain, social function, mental health, vitality and overall health in the operation group were significantly higher than those in the other two groups. The score of simultaneous radiotherapy and chemotherapy group was significantly higher than that of intensity modulated radiotherapy and chemotherapy group (P 0.05). The number of patients with pharyngeal fistula, dysphagia, dysphagia and dyspnea in the reserving operation group was significantly higher than that in the other two groups (P < 0.05). Conclusion the choice of laryngectomy in laryngeal preservation strategy is effective in clinical practice and can improve the quality of life and reduce postoperative complications.
【作者单位】：河北北方学院附属第一医院耳鼻咽喉头颈外科;张家口市万全区医院耳鼻咽喉头颈外科;
【分类号】：R739.65

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