CO_2激光手术治疗声门型喉癌疗效分析  

Evaluate the curative effect of CO_2 laser in treatment of glottic carcinoma

作　　者：黄志刚[1] 韩德民[1] 于振坤[1] 倪鑫[1] 葛秀明[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730

出　　处：《中华耳鼻咽喉科杂志》2002年第3期219-222,共4页Chinese Journal of Otorhinolaryngology

摘　　要：目的　总结CO2 激光手术治疗声门型喉癌的临床治疗效果。方法　对 1992年 8月～1998年 4月激光手术治疗的 2 17例声门型喉癌进行临床分析。 2 17例中原位癌 (Tis) 2 2例 ,T1a病变10 8例 ,T1b病变 38例 ,T2病变 4 6例 ,T3病变 3例。术后随诊 3～ 9年。结果　 2 17例支撑喉镜下CO2激光手术后 2 1例局部复发 ,局部复发率为 9 7% (2 1/2 17)。T1a复发率 5 6 % (6 /10 8) ,T1b复发率2 1 1% (8/38) ,T2复发率 13 0 % (6 /46 ) ,T3复发率 (1/3) ,组间差异有显著性 (χ2 值 =6 10 2 ,P <0 0 1)。病变侵犯前联合复发率 2 1 6 % (13/6 0 ) ,病变未侵犯前联合复发率 5 1% (8/15 7) ,两组间差异有显著性 (χ2 值 =13 6 4 ,P <0 0 1)。 2 17例激光手术治疗的患者 ,2 0 1例存活 ,失访 4例 (按死亡计算 ) ,死亡12例。 3年生存率 97 2 % (2 11/2 17) ,5年生存率 89 4 % (118/132 )。结论　激光手术治疗早期声门型喉癌疗效可靠 ,喉功能保全好 。Objective To evaluate the curative effect of CO 2 laser in treatment of glottic carcinoma Methods Retrospective analysis of 217 cases of early glottic laryngeal carcinoma treated with laser surgery were carried out Among these cases,Tis were 22 cases,T1a 108 cases,T1b 38 cases,T2 46 cases,T3 3 cases 1 case being applied vocal cord excision due to failure of tumor exposure The follow up period was 3 to 9 years Results Relapse were detected in 21 out of 217 cases of glottic laryngeal carcinoma after CO 2 laser surgery under self retaining laryngoscope The recurrent rate was 9 7% (21/217) Recurrent ratio of T1a,T1b,T2,T3 were 5 6%(6/108),21%(8/38),13 0%(6/46),1/3 respectively,with significant differences among groups (χ 2=6 102, P <0 01) The recurrent rate was 21 6% of tumors offended the anterior commissure,versus 5 1%(8/157) with no involvement of anterior commissure (χ 2=13 64, P <0 01) 217 cases received laser surgery as the only treatment,201 cases were still alive 4 failed to be followed up( taken into dead number),12 cases were dead 3 year survival rate was 97 2%(211/217),5 year survival rate was 89 4%(118/132) Conclusion It was reliable to use laser surgery in treatment of early glottic laryngeal cancer The advantages of it included lower complication rate and vocal function was well retained

关 键 词：CO2激光 手术治疗 声门型喉癌 疗效 

分 类 号：R739.65[医药卫生—肿瘤]