全喉切除术后气管感染对喉癌患者肺功能及肿瘤复发率的影响

doi:10.6040/j.issn.1673-3770.0.2015.449

摘要/Abstract

摘要： 目的探讨全喉切除术后气管感染对喉癌患者肺功能及复发情况的影响。方法选取喉癌患者276例,其中行喉癌全喉切除术者149例,全喉切除术+颈部淋巴结清扫者127例,观察患者术后感染情况、肺功能及复发情况。结果术后发生感染26例(9.42%),喉癌全切术感染发生率为4.03%(6/149),全切+淋巴结清扫感染率为15.75%(20/127),二者比较,差异具有统计学意义(P<0.05)。手术时间<4 h的患者感染率为2.11%(3/142),低于4~6 h的11.76%(11/102)及>6 h的37.50%(12/32),且4~6 h的感染率低于>6 h的感染率,差异均具有统计学意义(P<0.01);与术前比较,术后气管感染组患者FEV₁%明显升高,V25明显降低;感染患者肿瘤复发率为34.62%明显高于未感染患者的2.00%(P<0.01)。结论喉癌患者全喉切除术后肺功能有一定变化,且存在一定的感染复发风险,应采取措施尽可能降低感染发生,改善预后。

关键词: 肺功能, 安全性, 气管感染, 复发, 喉癌全切术

Abstract: Objective To explore the influence of tracheal infection after total laryngectomy on pulmonary function and tumor recurrence rate in patients with laryngocarcinoma. Methods A total of 276 patients with laryngocarcinoma were selected, in which 149 received total laryngectomy, and 127 received total laryngectomy plus neck lymph node dissection. Postoperative infection, pulmonary function and recurrence conditions of all patients were observed. Results Totally 26(9.42%)patients had postoperative infection, in which the infection rate of patients with total laryngectomy was 4.03%(6/149)whereas that of patients with total laryngectomy plus neck lymph node dissection was 15.75%(20/127), and there was significant difference(P<0.05). The infection rate was 2.11%(3/142)in patients with surgical duration <4 h, 11.76%(11/102)in patients with surgical duration < 4-6 h and 37.50%(12/32)in patients with surgical duration>6 h, and the rate of patients with surgical duration < 4-6 h was markedly lower than that >6 h(P<0.01). Compared with surgery before, forced expiratory volume in 1 second(FEV₁)increased obviously while V25 reduced markedly in patients in postoperative tracheal infection group. The tumor recurrence rate was 34.62% in patients with tracheal infection, significantly higher than the 2.00% in those with non-infection(P<0.01). Conclusion Patients with laryngocarcinoma have certain improvement in pulmonary function and risk of infection and recurrence after total laryngectomy, so effective measurements should be conducted to reduce the infection rate and promote patients’ prognosis.

Key words: Laryngocarcinoma, Safety, Tracheal infection, Pulmonary function, Recurrence

中图分类号:

R765.2

晋舒. 全喉切除术后气管感染对喉癌患者肺功能及肿瘤复发率的影响[J]. 山东大学耳鼻喉眼学报, 2016, 30(3): 37-39.

JIN Shu. Influence of tracheal infection after total laryngectomy on pulmonary function and tumor recurrence rate in patients with laryngocarcinoma.[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(3): 37-39.

参考文献

[1] 唐芳. 咽喉癌全喉全食管切除术患者的围手术期护理[J]. 中国实用护理杂志, 2012, 28(17):31-32. TANG Fang. Peri-operative nursing of pharyngolaryngeal cancer patients with total laryngectomy and esophagectomy[J]. Chin J Prac Nurs, 2012, 28(17):31-32.
[2] 刘红兵, 刘月辉, 罗英, 等. 喉癌的手术方式选择及远期疗效的分析[J]. 中国癌症杂志, 2015, 25(2):145-149. LIU Hongbing, LIU Yuehui, LUO Ying, et al. Analysis of surgical methods and clinical analysis of its long-term effect of laryngeal carcinoma[J]. Chin Oncol, 2015, 25(2):145-149.
[3] 吴娇娇, 黄志刚, 房居高, 等. CO₂激光手术治疗喉癌的并发症分析[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46(2):118-122. WU Jiaojiao, HUANG Zhigang, FANG Jugao, et al. Complications of CO₂ laser surgery in the treatment of laryngeal carcinoma[J]. Chin J Otorhinolaryngol Head Neck Surg, 2011, 46(2):118-122.
[4] 方利, 龚敏, 赵良淑, 等. 喉癌患者术后呼吸道的系统化安全管理[J]. 重庆医学, 2013, 42(14):1673, 1680. FANG Li, GONG Min, ZHAO Liangshu, et al. Systematic safety management for airway of patients with laryngocarcinoma after surgery[J]. Chongqing Med, 2013, 42(14):1673, 1680.
[5] 孙旭云, 谷京城, 张玉玲, 等. 122例辽西地区喉癌患者术后生存率与生存质量的相关因素分析[J]. 山东医药, 2011, 51(40):104-106. SUN Xuyun, GU Jingcheng, ZHANG Yuling, et al. Analysis of relative factors for survival rates and quality of life in patients with laryngocarcinoma in Liaoxi, a report of 122 cases[J]. Shandong Med J, 2011, 51(40):104-106.
[6] 李伟宁, 陈韵彬, 刘辉, 等. 喉癌行全喉切除术后CT表现[J]. 中国医学影像学杂志, 2010, 18(5):457-460. LI Weining, CHEN Yunbin, LIU Hui, et al. Ct appearances of postoperative changes in patients with total laryngectomy for carcinoma[J]. Chinese J Med Imaging, 2010, 18(5):457-460.
[7] 张红伟, 杨璞, 王凤娟, 等. 改良气管滴药法在喉癌术后患者气道湿化中的应用[J]. 护理学杂志, 2012, 27(8):29-30. ZHANG Hongwei, YANG Pu, WANG Fengjuan, et al. Modified intermittent endotracheal drug administration for humidification after laryngeal cancer resection[J]. J Nurs Sci, 2012, 27(8):29-30.
[8] 李晓明, 邵永良, 邸斌, 等. 喉癌部分喉切除术后复发的挽救治疗效果分析[J]. 临床误诊误治, 2011, 24(7):63-65. LI Xiaoming, SHAO Yongliang, DI Bin, et al. Clinical effect of salvage therapy for laryngeal carcinoma recurrence after partial laryngectomy[J]. Clin Misdiag Misther, 2011, 24(7):63-65.
[9] 朱肇峰, 王跃建, 梁玉颜, 等. 喉次全切除术后喉功能恢复远期随访评价[J]. 广东医学, 2011, 32(12):1590-1591. ZHU Zhaofeng, WANG Yuejian, LIANG Yuyan, et al. Evaluation of long-term follow up of laryngeal function rehabilitation after subtotal laryngectomy[J]. Guangdong Med J, 2011, 32(12):1590-1591.
[10] 张敏, 王永良. 全喉切除术与喉部分切除术治疗喉癌的效果比较[J]. 中国医药导报, 2015, 12(9):118-121. ZHANG Min, WANG Yongliang. Effect comparison of total laryngectomy and partial layngectomy in the treatment of laryngeal carcinoma[J]. Chin Med Herald, 2015, 12(9):118-121.
[11] 张玉枝, 吴爱琴, 王洪凤. 喉癌术后患者气道护理的研究进展[J]. 中华现代护理杂志, 2013, 19(13):1611-1612. ZHANG Yuzhi, WU Aiqin, WANG Hongfeng. Advances of airway nursing after surgery in patients with laryngocarcinoma[J]. Chin J Modern Nurs, 2013, 19(13):1611-1612.
[12] 谢迁, 曹彬, 魏永祥, 等. 喉癌术后手术部位感染情况调查及危险因素分析[J]. 第二军医大学学报, 2011, 32(5):521-523. XIE Qian, CAO Bin, WEI Yongxiang, et al. Study on surgical site infection following laryngectomy and its risk factors[J]. Acad J Sec Military Med Univ, 2011, 32(5):521-523.
[13] 卢仲明, 张思毅, 宋新汉, 等. 全喉切除术后气管造瘘口复发癌的手术治疗[J]. 实用医学杂志, 2012, 28(10):1667-1668. LU Zhongming, ZHANG Siyi, SONG Xinhan, et al. Surgical treatment of tracheostomy recurrent cancer after whole laryngectomy[J]. J Prac Med, 2012, 28(10):1667-1668.
[14] Stephen J K, Symal M, Chen K M, et al. Molecular characterization of late stomal recurrence following total laryngectomy[J]. Oncol Reports, 2011, 25(3):669-676.

相关文章 15

[1]	刘南仙,杨泽垠,韩琳,张爱英,赵宇亮,薛静,孙怡君,邵永良. 视频脑电图在儿童复发性眩晕诊断中的意义[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 20-25.
[2]	刘怡君,谷悦,官大宇,杨玉成,沈暘. 翼管神经切断术在难治性变应性鼻炎中远期临床疗效和安全性[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 42-48.
[3]	王再兴,唐志元,李定波,石照辉,曾宪海,张秋航. 鼻咽癌放疗后肿瘤复发及颅底骨坏死引起颈内动脉破裂的治疗方案[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 49-58.
[4]	王文晴,张丹,朱梦迪,王路阳,杨培培,孙思思,张秋敏,周慧. 慢性鼻窦炎伴鼻息肉复发手术时临床及组织病理学特征变化[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 46-53.
[5]	赵佳宁,崔元馨,王丹,赵明. 咽喉反流与复发性呼吸道乳头状瘤病的关系及其机制探讨[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 39-45.
[6]	李婷,赵冲,吴献. 鼻黏膜组织中miR-34a表达与慢性鼻窦炎患者术后复发的关系[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 20-25.
[7]	王桂芳,李仁高,马青. H-UPPP联合低温等离子舌根射频消融术对OSAHS患者血氧饱和度及动脉血氧分压的影响[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 49-54.
[8]	崇维琨,王娟. 联合应用奥马珠单抗在儿童中重度变应性哮喘合并慢性鼻窦炎中的疗效观察[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 21-26.
[9]	李卓君,宋西成,陈秀梅. 阻塞性睡眠呼吸暂停低通气综合征患者的肺功能变化分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 45-50.
[10]	吕萍,李丹丹,宋伟,洪流. 鼻内镜辅助下鼻泪道再通术治疗新生儿期泪囊炎[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 71-74.
[11]	孙浩, 杨会,李姣. 后部葡萄膜黑色素瘤活检及其临床意义的研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 152-156.
[12]	袁晨阳, 刘燕, 房振胜. 儿童阻塞性睡眠呼吸暂停低通气综合征对肺功能的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 143-148.
[13]	齐雯雯,陈鲁秋,贾涛,陈雪梅,张杰,张皓,金鹏,张虎. 复发性喉乳头状瘤中潜在生物学标志物的筛选及生物信息学分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 75-84.
[14]	范黎,黎越,徐细明. 鼻咽癌同步放化疗前后炎性指标变化及预测价值[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 36-41.
[15]	陈建勇, 孙夏雨, 沈佳丽, 汪玮, 王璐, 贺宽, 张勤, 马孝宝, 沈敏, 陈向平, 杨军. 原发性良性阵发性位置性眩晕患者VEMP异常率的临床观察[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 51-55.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed