Nd:YAP激光辅助的声带黏膜部分剥脱术治疗喉角化症  

Nd:YAP laser assisted partial mucosa stripping surgery of vocal cords for the treatment of Laryngeal keratosis

作　　者：关中[1] 龚坚[1] 龙桦[1] 陈秋坚[1] 叶辉[1] 彭解人[1] 许耀东[1] 郑亿庆[1] 

机构地区：[1]中山大学附属第二医院耳鼻咽喉科,广州510120

出　　处：《中国中西医结合耳鼻咽喉科杂志》2007年第1期40-42,共3页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的 观察Nd：YAP激光辅助的声带黏膜部分剥脱术治疗喉角化症的疗效。方法 2001年12月～2005年2月本科收治的21例喉角化症患者，于全麻下行支撑喉镜喉显微手术，对病变声带施行部分剥脱术，辅以Nd：YAP激光束非接触式烧灼声带创面及切缘，术后随访1～4年。比较术前及术后3个月时的嗓音频率微扰值、振幅微扰值、标准声门噪音能量值、基频等参数。结果 17例患者一次性治愈（81．0％），另4例于术后6个月内复发（19．0％）而再次手术。再次手术患者中，1例于1年后局部发生癌变（4．8％）。术后Jitter、Shimmer、NNE等参数均有显著改善（P≤0．05），仅F0无明显变化。结论 Nd：YAP激光辅助的声带黏膜部分剥脱术治疗喉角化症具有创伤小、嗓音恢复良好、复发少等优点，可有效减少喉角化症的恶变机率。Objective To evaluate the therapeutic effect of Nd： YAP laser assisted partial mucosa stripping surgery of vocal cords for the treatment of laryngeal keratosis. Methods A retrospective study was carried out among 21 cases with laryngeal keratosis, treated in our Hospital from Dec 2001 to Feb 2005. They were operated on by partial mucosa stripping surgery of vocal cords under general anaesthesia and sustained laryngoscope at first. Then, the surface of surgical wound and its edge were coagulated by Nd：YAP laser in a way of non-contact. All the cases were followed up for 1 to 4 years. Acoustic parameters, such as pitch period perturbation （Jitter）, amplitude perturbation （Shimmer）, glottal noise energy （NNE）, and fundamental frequency （F0）, were recorded and comparatively ana- lyzed before and three months after the operation by using Dr. Speech Science for Windows Software. Results In this group of patients, seventeen cases （81.0%） were cured only by once surgery, and 4 reocurred within 6 months after the operation, with a recurrence rate of 19.0% （4/21）. Among the reoccurred cases, one underwent to malignant development in two years. There was significant improvement in such acoustic parameters as Jitter, Shimmer, NNE and F0 following the operation（P≤0.05）, with only the parameter of F0 showing no significant changes after the surgery, Conclusion These minimally invasive procedures, which are reliably efficient for the treatment of laryngeal keratosis, can reduce the recurrence rate largely, improve the voice quality much better and prevent the le- sion from malignant developing effectively.

关 键 词：喉角化症 声带黏膜部分剥脱术 激光辅助治疗 疗效 

分 类 号：R767[医药卫生—耳鼻咽喉科] R739.65[医药卫生—临床医学]