喉非特异性肉芽肿的治疗  

Treatment of laryngeal granuloma

作　　者：农东晓[1] 农辉图[1] 徐志文[1] 唐安洲[1] 王安宇[2] 

机构地区：[1]广西医科大学第一附属医院耳鼻咽喉-头颈外科,南宁530021 [2]广西医科大学附属肿瘤医院放射治疗科,南宁530021

出　　处：《临床耳鼻咽喉头颈外科杂志》2007年第14期649-651,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:研究非特异性喉肉芽肿的治疗方法。方法:回顾分析1998～2005年经组织病理确诊的25例非特异性喉肉芽肿患者,均以手术联合非手术冶疗,口服制酸剂、吸入类固醇,语音治疗等综合治疗,2例低剂量放射治疗。结果:手术加非手术治疗复发率都极高,术后2～3个月内复发,反复手术达3～5次。手术联合非手术治疗中,插管性肉芽肿8例,治愈6例,缩小2例。接触性肉芽肿8例,语音治疗治愈6例,缩小2例。胃食管反流9例,制酸治疗治愈6例,缩小2例,1例经前述治疗2个疗程后癌变。2例加用放疗冶愈,随访18个月无复发。结论:虽然喉非特异性肉芽肿有强烈的复发倾向,但其治疗仍以手术联合非手术治疗为主,包括制酸、局部吸入类固醇,语音疗法等综合治疗,对前述治疗无效者,低剂量放射治疗是一种较安全有效的疗法。Objective：To study treatment method of laryngeal nonspecific granuloma. Method：Twenty-five patients with histopathologically identified laryngeal nonspecific granuloma were retrospective reviewed from 1998- 2005. All patients were surgically treated by laser laryngomicrosurgery under general anesthesia, postoperative non-operative therapies included anti-gastroesophageal reflux medication, topical inhalant steroid （Beclometasone, Futicasone） and voice therapy. Two patients were treated with 12 Gy of low-dose radiotherapy after surgery. Result： Laryngeal nonspecific granuloma have remarkable tendency of recurrence despite of surgery and non-surgical managements. Recurrence of laryngeal nonspecific granuloma occurs between 2-3 months postoperatively and requires repeated operation for 3-5 times. For intubation granuloma, 6 out of 8 were healed. Six out of eight contact granulomas were healed. Six of gastroesophageal reflux granulomas were healed. Glottic carcinoma was demonstrated in one case after 2 sessions of combined managements. Two patients were completely healed by low-dose radiotherapy of 12 Gy. Conclusion：Laryngeal nonspecific granuloma have an obvious tendency of recurrence, how- ever, surgery is an important therapy. Combined non-surgical therapies （anti-gastroesophageal reflux medication, topical inhalant steroid and voice therapy） are necessary. In case which routine ways fail to control recurrence, low-dose radiotherapy is recommended because of its safety and satisfied effect.

关 键 词：肉芽肿 喉 制酸治疗 类固醇激素 语音治疗 放射治疗 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]