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目的探讨“Z”成形术在喉全切除术后气管造瘘中的应用。方法 2009年12月-2011年12月对78例行喉全切除术患者术中同期采用“Z”成形术行气管造瘘术,术后随访测量造瘘口直径大小。结果 78例气管造瘘术患者气管造瘘口直径在术后第1天为(3.26±0.14)cm,术后3个月为(2.72±0.18)cm,术后6个月为(2.23±0.17)cm,术后1年为(2.04±0.14)cm;随访2年,1年后造瘘口直径趋于稳定,未再继续缩窄;所有患者全部脱管,脱管时间为6个月,无患者出现造瘘口狭窄、呼吸困难。结论 “Z”成形术操作方便,应用于喉全切除术后气管造瘘可以很好地预防气管造瘘口狭窄。
Objective To investigate the application of “Z” plasty in tracheal fistula after total laryngectomy. Methods From December 2009 to December 2011, 78 patients undergoing total laryngectomy were treated with “Z” plasty at the same period during operation. The diameter of the ostomy was measured after operation. Results The diameter of tracheostomy in 78 patients with tracheostomy was (3.26 ± 0.14) cm on the first postoperative day, (2.72 ± 0.18) cm at 3 months and (2.23 ± 0.17) at 6 months after operation ) cm in one year and (2.04 ± 0.14) cm in one year after operation. The diameters of the fistulas tended to be stable after one year and two years follow-up. All the patients underwent catheterization and catheterization for 6 months, No patient appeared stoma stenosis, breathing difficulties. Conclusion “Z ” angioplasty is easy to operate, and tracheostomy after laryngectomy can prevent tracheal stenosis.