为了观察全喉切除术后语言康复重建的效果 ,我们随访 1987年～ 1997年行气管食管瘘发音重建术的患者 16 9例 ,其中直接法 6 3例 ,瓣膜法 10 6例。我们分别观察术后 3周及术后 5年的发音效果。结果发现直接法有发音效果快 ,易掌握的特点 ,但需要不断更换发音钮。瓣膜法具有发音效果稳定的优点 ,但术式较复杂 ,精确度高 ,术后感染可影响发音效果。相比之下瓣膜法更适合广大患者。 In order to observe the effect of language rehabilitation after total laryngectomy, we followed 196 patients undergoing tracheo-esophageal fistula reconstructive surgery from 1987 to 1997, of which 63 were direct and 106 were valved. We observed the vocal effects 3 weeks postoperatively and 5 years postoperatively. As a result, it was found that the direct method has the characteristics of fast pronunciation and easy to grasp, but it requires constant replacement of the pronunciation button. The valve method has the advantages of stable sounding effect, but the operation method is more complicated and the precision is high. Postoperative infection can affect the pronunciation effect. In contrast, the valve method is more suitable for the majority of patients.