原发性喉淀粉样变的临床分析  

Clinical analysis of primary laryngeal amyloidosis

作　　者：李燕萍[1] 何时知 刘亚超[1] 

机构地区：[1]河北北方学院附属第一医院耳鼻咽喉头颈外科,河北张家口075000 [2]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：《中国耳鼻咽喉颅底外科杂志》2017年第1期78-80,共3页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的探讨原发性喉淀粉样变的临床特征及诊疗方法。方法回顾性分析首都医科大学附属北京同仁医院2015年4月~2016年4月收治的14例原发性喉淀粉样变患者的临床资料,14例患者中男2例,女12例;年龄24~61岁,平均年龄(47±10)岁;病程3个月至1.5年,平均(3.7±4.3)年。所有患者均在全麻下行支撑喉镜下CO_2激光喉肿物切除术。结果 1例因双室带前1/3肉芽组织生成术后症状改善不明显,术后第9天行全麻支撑喉镜下肉芽组织清除术。所有患者随访2个月至1年,声嘶症状均明显改善,均未见肿物复发。结论原发性喉淀粉样变病因不明,手术治疗是最重要的治疗方式,推荐支撑喉镜下CO_2激光手术切除;病理组织检查刚果红染色阳性、偏振光呈苹果绿双折射是诊断该病最特异的依据。Objective To study the clinical features, diagnosis and treatment of primary laryngeal amyloidosis. Methods Clinical data of 14 patients suffering from primary laryngeal arnyloidosis were retrospectively analyzed. All the patients received surgical treatment in Beijing Tongren Hospital from April 2015 to April 2016. Of them, 2 were male and 12 were female. Their age ranged from 24 to 61 years old with an average of （47 ± 10）. The disease course ranged from 3 months to 15 years with an average of （3.7 ± 4.3） years. Results CO2 laser removal of laryngeal amyloidosis with self- retaining laryngoscope under general anesthesia was performed to all patients. One patient with insignificant symptom improvement due to granulation tissue on bilateral ventricular bands received removal of granulation tissue under general anesthesia 9 days after the initial operation. Postoperative follow-up of 2 months to one year showed obvious relief of hoarseness. No recurrence occurred. Conclusion The etiology of primary laryngeal amyloidosis is unknown. It occurs mainly in the middle-aged. Ventricular bands, ventricles of larynx and vocal cords are the most frequent sites of origin. Hoarseness and dyspnea are the most common symptoms. Laryngoscopy usually shows nodular projection or diffuse submucosal mass. Surgical operation is the most important method for this disease, especially CO2 laser-assisted laryngeal microsurgery. Positive Congo red staining and ＂ apple-green＂ birefringence with polarized light are the most specific histopathological characteristics for the diagnosis of laryngeal amyloidosis.

关 键 词：喉淀粉样变 喉良性肿瘤 

分 类 号：R767.1[医药卫生—耳鼻咽喉科]