【摘要】 目的 探讨全喉切除术后患者发生咽瘘的原因,以降低咽瘘的发生率。方法 回顾分析167例喉癌、下咽癌患者行全喉切除术后发生咽瘘的原因。结果 167例患者咽瘘发生率为14.97%，与术前放疗、术前气管切开、患者血红蛋白浓度；术中缝线、负压引流、切除范围；术后感染、鼻胃管拔除时间、甲状腺功能低下、术后呕吐、瘘口复发癌等因素有关。结论 全喉切除术后发生咽瘘的原因是多方面的，避免相关因素，能有效降低咽瘘的发生率，提高患者生存质量。

    【关键词】 全喉切除术；咽瘘

    Discussion on causes of pharyngeal fistula after total laryngectomy

    GUO Zhi-gang，ZHANG Cai-qin，GAO Lei-shun，et al.

    The 285th Hospital of PLA,Handan 056001,China

    【Abstract】 Objective To study the causes of pharyngeal fistula after total laryngectomy,reduce the rate of pharyngeal fistula.Methods The causes of pharyngeal fistula in 167 cases with total laryngectomy were retrospectively analyzed.Results The rate of pharyngeal fistula of 167 cases was 14.97%.The pharyngeal fistula had the relation with radio therapy before total laryngectomy, tracheotomy, HGB before operation,suture, drainage, removal range;infection,the time of detubation of stomach tube,thyroid ......