不同临床形态声带息肉手术方式的选择  

Selection of surgical procedures for different clinical shapes of vocal cord polyps

作　　者：徐志鸿[1] 何锦添[1] 钟景良[1] 

机构地区：[1]东莞市人民医院耳鼻咽喉科,广东东莞523059

出　　处：《海南医学》2013年第2期190-192,共3页Hainan Medical Journal

基　　金：广东省东莞市科技局资助项目(编号:201110515000313)

摘　　要：目的探讨不同临床形态声带息肉手术方式的选择。方法回顾性分析我科声带息肉手术患者346例,根据喉镜图片及病理结果将其分为5型:水肿型124例、血管扩张型65例、纤维型88例、出血型和出血血栓型38例、淀粉样变性型31例。比较不同类型采用电子喉镜和支撑喉镜手术的疗效。结果水肿型、血管扩张型、出血型和出血血栓型采用电子喉镜及支撑喉镜手术的疗效比较差异无统计学意义(P>0.05);纤维型和淀粉样变性型采用支撑喉镜手术的疗效明显高于采用电子喉镜手术(P<0.05)。电子喉镜下手术患者均未出现并发症,支撑喉镜下手术患者中有21例出现并发症。结论水肿型、血管扩张型、出血型和出血血栓型声带息肉采用电子喉镜即可安全、有效的完成手术,纤维型和淀粉样变性型以采用支撑喉镜完成手术为佳。Objective To discuss the selection of surgical procedures for treating different clinical shapes of vocal cord papas. Methods The clinical data of 346 patients with vocal cord polyps were analyzed retrospectively. The vocal cord polyps were classified into 5 types according to the clinical shape of vocal cord polyps and their patho- logical features： edematous type in 124 cases, vascular type in 65 cases, fibrous type in 88 cases, hemorrhagic or thrombotic type in 38 cases, and amyloid type in 31 cases. The therapeutic effects of surgical procedure with electron- ic laryngoscope and suspension laryngoscope on different shapes of vocal cord polyps were compared. Results For vocal cord polyps of edematous type, vascular type and hemorrhagic type, there were no significant differences in clin- ical effects with electronic laryngoscope and suspension laryngoscope operation （P〉0.05）. For vocal cord polyps of fi- brous type and amyloid type, the effect of suspension laryngoscopic surgery group was significnaly better than that in electronic laryngoscopie surgery group （P〈0.05）. There were 21 complications in suspension laryngoscopic surgery group, without any complications in electronic laryngoscopic surgery group. Conclusion For vocal cord polyps of edematous type, vascular type and hemorrhagic type, it is safe and effective to complete the operation with electronic laryngoscope, but for the vocal cord polyps of fibrous type and amyloid type, suspension laryngoscopic surgery should be applied.

关 键 词：声带息肉 喉镜检查 手术 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]