环状软骨上喉部分切除术与全喉切除术对中晚期喉癌患者血清let-7a CK18水平及无瘤生存期的影响对比

doi:10.3969/j.issn.1006-6233.2023.07.020

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摘要 目的: 对比环状软骨上喉部分切除术与全喉切除术对中晚期喉癌患者的影响。方法: 选取我院2016年2月至2019年6月期间收治的105例中晚期喉癌患者作为研究对象,根据手术方案的不同分为对照组(n=50)和观察组(n=55),对照组行全喉切除术,观察组行环状软骨上喉部分切除术,术后均随访3年。比较两组患者围手术期指标[术后引流量、鼻饲时间、试吃开始时间、住院时间]、术后并发症情况、术前及术后血清let-7a、CK18水平、吞咽功能变化及无瘤生存期。结果: 观察组各项围术期指标均优于对照组(P<0.05);观察组术后7d并发症总发生率为低于对照组(P<0.05);观察组吞咽功能等级优于对照组(P<0.05);观察组术后血清let-7a高于对照组(P<0.05),CK18低于对照组(P<0.05);两组3年总生存率差异无统计学意义(P>0.05)。结论: 环状软骨上喉部分切除术治疗中晚期喉癌患者,可显著改善围手术期指标、血清指标及吞咽功能,并发症少,远期预后与全喉切除术相当,值得推广。

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	李志勇
	杨荃荃
	马鹏
	冯俊

关键词 ：环状软骨上喉部分切除术, 全喉切除术, 中晚期喉癌, 无瘤生存期

Abstract：Objective: To compare the effects of supracricoid partial laryngectomy and total laryngectomy on patients with advanced laryngeal cancer. Methods: A total of 105 patients with advanced laryngeal cancer in the hospital from February 2016 to June 2019 were selected as the research subjects,and they were classified into control group (n=50) and observation group (n=55) by means of different surgical regimens.The control group underwent total laryngectomy while the observation group received supracricoid partial laryngectomy.The patients were followed up for 3 years after surgery.The perioperative indicators[postoperative drainage volume,nasal feeding time,trial eating start time,hospital stay],postoperative complications,levels of serum let-7a and CK18 before and after surgery,swallowing function and tumor-free survival were compared between groups of patients. Results: The various perioperative indicators in observation group were better than those in control group (P<0.05).The total incidence rate of complications in observation group at 7 days after surgery was lower compared with that in control group (P<0.05).The swallowing function grading in observation group was better compared to control group (P<0.05).After surgery,the level of serum let-7a in observation group was higher (P<0.05) while the CK18 was lower than that in control group (P<0.05).There was no statistical difference in the 3-year overall survival rate between both groups (P>0.05). Conclusion: Supracricoid partial laryngectomy in the treatment of patients with advanced laryngeal cancer can significantly improve the perioperative indicators,serum indicators and swallowing function.In addition,it has few complications and its long-term prognosis is comparable to that of total laryngectomy.

Key words： Supracricoid partial laryngectomy Total laryngectomy Advanced laryngeal cancer Tumor-free survival

基金资助:四川省卫生和计划生育委员会科研课题,(编号:17PJ407)

通讯作者: 杨荃荃

引用本文:

李志勇, 杨荃荃, 马鹏, 冯俊. 环状软骨上喉部分切除术与全喉切除术对中晚期喉癌患者血清let-7a CK18水平及无瘤生存期的影响对比[J]. 河北医学, 2023, 29(7): 1164-1168.
LI Zhiyong, YANG Quanquan, MA Peng, et al. Comparison of Effects of Supracricoid Partial Laryngectomy and Total Laryngectomy on Serum let-7a and CK18 Levels and Tumor-Free Survival in Patients with Advanced Laryngeal Ccancer. HeBei Med, 2023, 29(7): 1164-1168.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.07.020 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I7/1164

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