成人喉乳头状瘤64例CO2激光黏膜下完整剥离术  

Therapy of adult-onset laryngeal papilloma：integrallty submucosal dissection of the tumor by CO2 laser

作　　者：雷文斌[1] 刘其洪[2] 柴丽萍[1] 祝小林[1] 王章锋[1] 李清明[2] 唐浩程[1] 蒋爱云[1] 文译辉[1] 文卫平[1] 

机构地区：[1]中山大学附属第一医院耳鼻咽喉科医院中山大学耳鼻咽喉科学研究所,广州510800 [2]中山大学附属第八医院耳鼻咽喉头颈外科,518033

出　　处：《中华耳鼻咽喉头颈外科杂志》2016年第10期727-732,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

摘　　要：目的 探讨和评价应用CO2激光黏膜下完整剥离术治疗成人喉乳头状瘤的可行性和手术疗效.方法 回顾性分析中山大学附属第一医院2009年至2015年收治的64例成人喉乳头状瘤患者的临床资料,其中男36例,女28例;年龄18 ～ 75岁,平均43.13岁;病灶多发54例,单发10例.64例患者均采用CO2激光沿黏膜下层将肿瘤连同基底膜及周围少许正常组织完整切除的手术方式,观察患者的肿瘤范围积分变化、手术间期、手术次数、术后近期声音质量、术后瘢痕形成、气管切开情况并进行分析评价.结果 64例患者术后随访时间1～5年,术前平均病灶肿瘤范围积分7.00分,术后肿瘤范围积分保持为0达1年以上的患者62例,临床治愈率达96.9％;平均手术间期为25.7个月;平均手术次数1.36次（64例患者共行87次手术）;瘢痕形成共4例（4/64）;术后近期声音质量4.25分.64例患者肿瘤范围积分均有不同程度下降,平均下降6.72分,缓解率100％.结论 CO2激光黏膜下完整剥离术治疗喉乳头状瘤,具有肿瘤范围积分下降显著、手术间期延长、手术次数减少、术后声音质量好的优势,大部分患者能达到临床治愈的疗效.Objective To evaluate the feasibility and efficacy of the integrallty submucosal resection of adult-onset laryngeal papilloma by CO2 laser.Methods A group of 64 cases （36 males and 28 females,multipe lesions 54 cases and single lesion 10 cases,aged 18-75 years,mean age 43.13 years） with adultonset laryngeal papilloma encountered in the first affliated hospital of Sun Yatsen university from 2009 to 2015 was retrospectively analyzed.All cases were treated with integrallty submucosal dissection of the tumor by CO2 laser,and observed the changes of tumor integral scope,inter-operative,operative processes,postoperative voice quality,postoperative scarring,and the tracheotomy conditions,which were analysed and evaluated.Results A total of 64 patients were followed up from 1 year to 5 years.Preoperative tumor integral scope of these patients averaged of 7.00.A total of 62 cases kept 0 score of the tumor integral scope for at least one year,which lead to a clinical cure rate of 96.9%.The inter-operative averaged of 25.7 months.The total operative processes of these patients were 87 times （mean time 1.36）.Four cases resulted in postoperative scarring.However these was a good result in postoperative voice quality with a mean score 4.25.As to the changes of tumor integral scope,all cases got a declining score （mean score 6.72）,which resulted in a remission rate of 100%.Conclusion The integrallty submucosal dissection of adultonset 1aryngeal papilloma by CO2 laser was an effective way to reduce the tumor integral scope;lengthen their inter-operative;decrease the operative processes,avoid the occurrence of tracheotomy;and improve the postoperative voice quality.Most of the patients could even be cured ultimately.

关 键 词：喉乳头状瘤 CO2激光 黏膜下 剥离术 完整 

分 类 号：R739.65[医药卫生—肿瘤]