郭冰洁　　温瑞芳　　王兰　　江子芳

[摘要] 全喉切除术是治疗中晚期喉癌的主要方法，可显著提高患者生存率，但手术也给机体的整体功能带来许多负面影响。嗅觉障碍是全喉切除术后患者常见问题之一且对患者的日常生活产生严重危害和影响，国外学者早已关注到全喉切除患者嗅觉障碍问题并开展干预研究，而国内却鲜见相关文献报道。本文对全喉切除患者嗅觉障碍的发生现状、恢复情况、发生原因、嗅觉功能评估方法及嗅觉功能康复的干预措施进行综述，旨在为我国医护人员促进全喉切除患者嗅觉功能康复提供借鉴。

[关键词] 全喉切除术;嗅觉障碍;评估方法;干预措施

[中图分类号] R765          [文献标识码] A          [文章编号] 1673-9701（2021）10-0181-06

Research progress on evaluation and intervention of olfactory disorders in patients with total laryngectomy

GUO Bingjie1   WEN Ruifang1   WANG Lan1， 2   JIANG Zifang1， 3

1.Zhejiang Chinese Medical University， Hangzhou   310053， China; 2.Department of Head and Neck Surgery， Zhejiang Cancer Hospital， Hangzhou   310022， China; 3.Department of Nursing， Zhejiang Cancer Hospital， Hangzhou   310022， China

[Abstract] Total laryngectomy is the primary method for the treatment of advanced laryngeal cancer， which can significantly improve the survival rate of patients. Still， surgery also brings many adverse effects on the overall function of the body. Olfactory dysfunction is one of the common problems of patients after total laryngectomy and has serious harm and impact on the daily life of patients. Foreign scholars have long paid attention to the problem of olfactory dysfunction in patients with total laryngectomy and conducted intervention studies， but there are few reports in domestic literature. This article reviews the current status， recovery status， causes， evaluation methods of olfactory function， and intervention measures for olfactory function rehabilitation in patients with a total laryngectomy， aimming to provide a reference for Chinese medical staff to promote the restoration of olfactory function in patients with total laryngectomy.

[Key words] Total laryngectomy; Olfactory disorders; Evaluation methods; Intervention measures

全喉切除術是治疗中晚期喉癌、原发声门下癌、放疗后复发者和下咽癌不能保留喉功能者的主要手术方法，能显著提高患者生存率[1]，但手术也给机体的整体功能带来许多负面影响，如发音功能丧失、嗅觉障碍等[2-3]。嗅觉障碍是指在气味感受、传导及信息分析整合过程中发生器质性和（或）功能性病变，导致的气味感知异常[4]，包括嗅觉减退、嗅觉丧失和幻嗅等不同类型。嗅觉障碍不仅降低患者对日常生活中的危险信号或有害因素（变质食物、火灾、烟雾和煤气泄漏等）的识别能力，而且影响患者的食欲及情绪，导致其生活质量下降[2，5-7]。目前国外关于全喉切除患者嗅觉障碍的研究较多，而国内缺乏相关文献报道。本文对全喉切除患者嗅觉障碍的发生现状、恢复情况、发生原因、嗅觉功能评估方法及干预措施等方面进行综述，以期为我国医护人员促进全喉切除患者嗅觉功能康复提供借鉴。……