T3期喉癌患者行全喉切除术与喉部分切除术治疗效果的对照分析

目的 探究T3期喉癌患者行全喉切除术与喉部分切除术的临床疗效.方法 回顾性分析80例T3期喉癌患者的临床资料,根据不同手术方式,将喉癌患者分为喉部分切除术组(PL组)和全喉切除术组(TL组),其中PL组有42例,TL组38例.切除手术后对全部患者进行门诊定期复查,电话随访等常规拜访.计算术后生存率和肿瘤复发率,评估术后喉功能恢复情况.对术后患者进行问卷调查并评分,评分标准是华盛顿大学生存质量表(UW-QOL),比较2组患者术后的生存质量状况.结果 PL组3、5年生存率分别为85.71％和73.81％,TL组3、5年的生存率分别为89.47％、78.93％,组间差异无统计学意义(P＞0.05).PL组患者术后3、5年间肿瘤复发率分别为11.90％、15.79％,对比于TL组的7.89％、13.15％,差异无统计学意义(P＞0.05).PL组和TL组患者术后并发症的发生率分别为2.38％和5.26％,组间并发症发生率差异无统计学意义(P＞0.05).PL组的生存质量评分为(686.50±127.50)显著优于TL组的(416.30±246.80),差异有统计学意义(P＜0.05).结论 喉部分切除术可以保留喉功能,显著提高T3期喉癌患者的生存质量,而全喉切除术亦可应用T3期喉癌患者,且两者并发症发生率低,均可应用于临床,可根据患者意愿选择.

Curative Effect of Total Laryngectomy and Partial Laryngectomy for Patients with T3 Laryngocarcinoma

Objective To discuss the curative effect of total]aryngectomy and partial laryngectomy for patients with T3 laryngocarcinoma.Methods According to the different operation mathods,80 patients with T3 laryngocarcinoma were analyzed retrospectively,and divided into 2 groups.42 patients treated with partial laryngectomy was taken as group of partial laryngectomy (PL),while 38 patients treated with total laryngectomy was taken as group of total laryngectomy(TL).All patients were given regular follow-up,and should calculate decannulation rate,survival rate and evaluate recovery condition after operation.Compared the score of UW-QOL with the 2 groups after treatment.Results The decannulation rate in PL group was 90.47％ and the same was 73.68％ in TL group,there had statistical significant difference.3-,5-year survival rates of PL group were 85.71％ and 73.81％,and 3-,5-year survival rates of TL group were 89.47 and 78.93 ％,the differences were not statistically significant (P ＞ 0.05).3-,5-year recurrence rates of PL group were 11.90％ and 15.79％,and 3-,5-year recurrence rates of TL group were 7.89％ and 13.15％,there was no statistical significant difference (P ＞ 0.05).The rate of postoperative morbidity was 2.38 ％ in the group PL and the same was 5.26％ in group TL,there had no statistical significant difference(P ＞ 0.05).The scores of survival quality in PL group (686.50 ± 127.50) was significantly higher than that in TL group (416.30 ± 246.80),there was statistical significant difference(P ＜ 0.05).Conclusion Partial laryngectomy can keep laryngeal function,improve the quality of life of patients with T3 laryngocarcinoma and total laryngectomy can also be used in T3 laryngocarcinoma.Both of them can decrease complications.According to patients'wishes,choose one of the them to use in clinical.