双侧任克水肿临床及病理分析  

Clinical and pathological analysis of Reinke edema

作　　者：杨越[1] 程磊[1] 吴海涛[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院耳鼻喉科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2017年第2期123-125,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：上海市科技创新行动计划(15401971600)

摘　　要：目的探讨任克水肿的临床和病理特点。方法回顾分析经手术治疗的168例双侧任克水肿患者的临床和病理资料。所有患者均有不同程度的声嘶,并在全身麻醉下行显微喉镜双侧任克水肿切除术。结果术后1周,双侧声带红肿,边缘不平,声嘶减轻56例、无变化73例、加重39例。159例患者2周后声嘶明显减轻,4周后逐渐恢复正常。3个月后,任克水肿治愈146例(86.9%)、好转22例(13.1%)。有25例(14.9%)病例于术后3~12个月复发。术后病理显示,124例(73.8%)存在鳞状上皮增生,其中异形增生21例(16.9%)。任克水肿伴上皮非异型增生、异型增生、角化和角化不全的发生率,男性分别为69.9%、81.0%、96.6%和92.9%;女性分别为30.1%、19.0%、3.4%和7.1%,差异均具有统计学意义。结论任克水肿好发年龄为41~60岁,男性高于女性。术后康复期长、容易复发。任克水肿鳞状上皮增生很常见,部分存在异型增生。术中保留一侧声带前端2~3 mm黏膜可预防双侧声带术后粘连。Objective To investigate the clinical and pathological features of Reinke edema. Methods All patients had hoarseness in different degrees and had undergone suspension microlaryngoscopic surgery under the general anesthesia for bilateral Reinke edema resection. Results The 168 cases showed bilateral vocal folds swollen with rough edge at 1 week after surgery,and 56 cases were improved,73 cases had no change and 39 cases were aggravated. Most cases were obviously improved at 2 weeks after surgery and gradually returned to normal at 4 weeks after surgery. Three months later,146 cases were cured（ 86. 9%）,22 cases were improved（ 13. 1%）. Recurrence occurred in 25 cases（ 14. 9%） at the 3 to 12 months after surgery. The pathological study showed that 124 cases had squamous epithelial hyperplasia,and 21 cases（ 16. 9%） had dysplasia. The prevalence rates of epithelial hyperplasia,dysplasia,keratinization and parakeratosis in male and female patients of Reinke edema were as follows： 69. 9%,81. 0%,96. 6%,and 92. 9% in male,and 30. 1%,19. 0%,3. 4%,7. 1% in female. The differences between male and female were significant（ P〈 0. 001）. Conclusions The predilection age of Reinke edema was 41 to 60 years old,and the incidence of men was higher than women. Postoperative recovery period of Reinke edema was long and prone to recurrence. Squamous epithelial hyperplasia is common in Reinke edema,and some exist pathologic dysplasia. Preserving the front-end 2 ~ 3 mm mucosa of unilateral vocal fold could prevent bilateral vocal cord adhesion after surgery.

关 键 词：任克水肿 声带 病理 

分 类 号：R767.91[医药卫生—耳鼻咽喉科]