声带任克水肿的临床特点及治疗原则  

Clinical Characteristics and Therapeutic Treatment Principle of Reinke's Edema of the Vocal Cord

作　　者：于萍[1] 王刚[1] 张贵娟[1] 孙艳松[1] 

机构地区：[1]解放军总医院耳鼻咽喉-头颈外科,北京100853

出　　处：《听力学及言语疾病杂志》2010年第6期571-574,共4页Journal of Audiology and Speech Pathology

摘　　要：目的探讨声带任克水肿(Reinke's edema)的病因及发病机制,分析其临床特点及治疗原则。方法对78例声带任克水肿患者的病因、流行病学特点、嗓音障碍特点进行分析,其中,29例患者进行戒烟及避免滥用嗓音并观察随访,49例患者接受嗓音外科手术,分析其疗效。结果声带任克水肿的发生与长期大量吸烟有关,多发生在中、老年患者,男性高于女性(男女之比为7.7∶1)。嗓音损害以声调下降最为明显,喉镜下表现为声带表面全长弥漫性水肿。29例非手术治疗的患者中,16例病变缩小,13例病变稳定。49例接受手术治疗的患者嗓音都有不同程度的改善,其中5例基本恢复正常(0级),34例仍有轻度障碍(1级),10例中度障碍(2级)。术后所有患者嗓音客观声学参数值都较术前改善,其中以基频改变为明显。但大部分患者仍存在一定程度的嗓音障碍。结论吸烟是导致声带任克水肿的重要原因,嗓音外科手术后嗓音恢复程度有限,应根据病变范围、嗓音障碍程度及患者职业等因素综合考虑是否手术治疗。Objective To explore the etiology and pathogenesis and to investigate the clinical characteristics and therapeutic treatment principle of Reinke＇s edema of the vocal cord.Methods In a retrospective study,78 patients with Reinke＇s edema were reviewed for etiology,epidemiology,acoustic analysis,subjective voice evaluation and surgical effects.Twenty-nine patients were followed up just by smoking abatement and 49 patients received phonosurgery.Results Reinke＇s edema was a predominant disease with a male vs female ratio of 7.7：1,mainly in senior patients.It was related to long-term smoking.The decreased pitch was the feature of voice and the laryngoscopic manifestation was diffuse edema on surface of the vocal cord.Of 29 non surgical patients,the extent of the lesion decreased in 16 patients and ahile in 13 patient showed no change.Phonosurgery could improve the voice predominately in increase of F0; however,most patients still suffered dysphonia to a certain degree.Conclusion Somking is an important etiological factor of Reinke＇s edema.The improvement of dysphonia is limited through phonosurgery.The extent of the lesion,degree of dysphonia and patient＇s profession should be considered for surgery candidates.

关 键 词：Reinke水肿 流行病学 嗓音障碍 嗓音外科 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]