声门上喉癌舌瓣修补术后吞咽功能恢复

doi:10.6040/j.issn.1673-3770.0.2019.622

摘要/Abstract

摘要： 目的探讨声门上型喉癌舌瓣修复术后患者吞咽功能恢复情况。方法选取原发部位为会厌的声门上喉癌且行水平半喉切除术后再使用舌瓣修复声门上结构的患者23例。运用中文版安德森吞咽困难量表,评估术前及术后吞咽功能,就患者情绪维度、社会功能维度、生理功能维度进行全面评估。结果 23例患者随访期间因肿瘤转移死亡2例、失访1例,完全恢复普通饮食20例,洼田饮水试验正常20例,术前总体吞咽得分中位数90.00［80.00,100.00］,术后得分中位数80.00［80.00,80.00］(P=0.359);情绪维度术前得分中位数91.67［77.50,93.33］,术后得分中位数80.00［80.00,83.33］(P=0.065);社会功能术前得分中位数90.00［80.00,96.00］,术后中位数84.00［80.00,92.00］(P=0.587);生理功能术前得分中位数83.75［76.25,89.38］,术后得分中位数80.00［75.00,84.38］(P=0.018)。结论声门上喉癌舌根未受累的患者,利用舌瓣修补声门上结构,术后均能恢复正常饮食习惯,在总体吞咽功能评分、情绪维度、社会功能维度均能获得较高的评分,在这三个方面术前及术后对比差异无统计学意义。舌瓣修补能较好地改善相关患者术后吞咽功能,提升患者术后生活质量。

关键词: 声门上恶性肿瘤, 舌瓣, 吞咽功能, 安德森吞咽困难量表, 修复, 评估

Abstract: Objective To investigate the swallowing function recovery on 23 cases of supraglottic laryngeal carcinoma postoperation. Methods From 2016 to 2019, a retrospective swallowing function analysis was performed on 23 cases of supraglottic laryngeal carcinoma. All of the patients underwent horizontal hemilaryngectomy and reconstruction with tongue flap. The M.D. Anderson Dysphasia Inventory(MDADI)was used to evaluate the swallowing function from emotional dimension, social function dimension, and physiological dimension before and after operation. Results 2 patients died during follow-up period.1 case lost follow-up. 20 patients recovered to normal diet. The overall swallowing median score was 90.00［80.00,100.00］, and the postoperative score median was 80.00［80.00,80.00］(P=0.359).The median score of emotion dimension was 91.67［77.50,93.33］, 80.00［80.00,83.33］(P=0.065)after operation. The median score of social function was 90.00［80.00,96.00］before surgery, and 84.00［80.00,92.00］(P=0.587)after surgery. Physiological function median score was 83.75［76.25,89.38］, 80.00［75.00,84.38］(P=0.018)after surgery. Conclusion Tongue flap can improve the swallowing function and the quality of patient life after the horizontal hemilaryngectomy.

Key words: Supraglottic laryngeal cancer, Tongue flap, Swallowing function, MDADI, Reconstruction, Evalution

中图分类号:

R767.91

谷少尉,侯元友,魏东敏,李文明,陈东彦,徐晨阳,雷大鹏,潘新良. 声门上喉癌舌瓣修补术后吞咽功能恢复[J]. 山东大学耳鼻喉眼学报, 2020, 34(5): 127-131.

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