支撑喉镜下CO_2激光声带粘连分离术联合曲安奈德声带黏膜下注射治疗声带粘连  

The adhesion separation operation with CO_2 laser combined with triamcinolone acetonide vocal cord submucosal injection for the treatment to vocal cord adhesion

作　　者：李俐华[1] 胡伟鹏 张智霖[1] 刘建国[1] 罗贵[1] 刘月辉[1] 

机构地区：[1]南昌大学第二附属医院耳鼻咽喉科,南昌330006 [2]宁都县人民医院耳鼻咽喉科

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第9期700-702,共3页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：江西省卫生计生委科技计划资质(No:20165222)

摘　　要：目的:探讨支撑喉镜下CO_2激光声带粘连分离术联合曲安奈德声带黏膜下注射治疗声带粘连的价值及预后转归。方法:16例声带粘连患者,2例儿童,14例成人;其中既往有双侧声带手术史(声带任克水肿、声带息肉、小儿喉乳头状瘤、喉癌)14例,喉结核2例。患者在全身麻醉支撑喉镜下行CO_2激光声带粘连分离术,术后第3天在电子喉镜下行声带黏膜下曲安奈德注射,连续3周,1次/周。全部患者每个月复查电子喉镜,随诊半年。结果:14例患者声带前连合均获得良好三角形声门裂形态,发声和呼吸均有明显改善。1例喉癌、1例喉结核患者在声带前连合仍旧残留有粘连带,但呼吸和发声有改善。结论:支撑喉镜下CO_2激光声带粘连分离术联合曲安奈德声带黏膜下注射对治疗声带粘连有效,有利于改善患者的呼吸及发声功能,创伤小,并发症少。Objective：To investigate the effect of adhesion separation operation with CO2 laser via prop-up laryngoscope combine with triamcinolone acetonide submucosal injection via electrolaryngoscope to vocal cords adhesion.Method：Sixteen cases of vocal cord adhesion patients（2 cases of children,14 cases of adult）were enrolled in the study.Fourteen patients had the history of surgery（Reinke edema,vocal polyp,pediatric laryngeal papilloma,laryngeal cancer）,2 cases were diagnosed as laryngeal tuberculosis.Adhesion separation operation and triamcinolone acetonide submucosal injection（once a week,three weeks）were conducted.All patients were examined with electronic laryngoscope every month for six monthes.Result：Fourteen patients had good triangle shape of glottis vocalis and good sound voice.One cases of laryngeal cancer and 1 cases of laryngeal tuberculosis patients still had adhesion in the anterior commissure of the vocal cords,but with the improvement in breathing and pronunciation.Conclusion：Adhesion separation operation with CO2 laser via prop-up laryngoscope combine with triamcinolone acetonide submucosal injection via electrolaryngoscope were effective for treatment to vocal cord adhesion,whichimprove the patient＇s breathing and voice with little trauma and few complications.

关 键 词：声带粘连 CO2激光 曲安奈德 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]