CO_2激光微创术与保守药物结合发音干预治疗血管性声带炎的临床研究  

CLINICAL EFFICACY OF CO2 LASER MINIMALLY INVASIVE SURGERY AND CONSERVATIVE DRUGS COMBINED WITH PRONUNCIATION INTERVENTION IN THE TREATMENT OF VASCULAR CHORDITIS

作　　者：叶刚[1] 罗文广[1] 张莉 Ye Gang;Luo Wenguang;Zhang Li(The People＇s Hospital of Leshan,Leshan 614000,China)

机构地区：[1]四川省乐山市人民医院,614000

出　　处：《中国煤炭工业医学杂志》2018年第3期274-277,共4页Chinese Journal of Coal Industry Medicine

基　　金：四川省卫生厅科研项目(编号:110341)

摘　　要：目的研究CO_2激光微创术与保守药物结合发音干预治疗血管性声带炎的临床疗效。方法选取我院2016年1月—2017年6月102例血管性声带炎患者为研究对象,按随机数表法分为观察组与对照组,每组51例。对照组给予保守药物结合发音干预治疗,观察组在对照组基础上给予CO_2激光微创术治疗。比较二组治疗30d后嗓音声学指标,统计频闪喉镜表现异常率,评估患者嗓音障碍指数。结果观察组治疗30d后基频微扰(Jitter)、振幅微扰(Shimmer)分别为(0.30±0.07)%、(1.89±0.42)%,显著低于对照组的(0.35±0.08)%、(2.14±0.47)%(P<0.05),谐噪比(HNR)为(23.12±3.47)dB,显著高于对照组的(21.65±3.25)dB(P<0.05)。观察组治疗30d后对称性与周期性异常率分别为41.2%、27.5%,显著低于对照组的60.8%、51.0%(P<0.05)。观察组治疗30d后嗓音障碍指数(VHI)总分为(32.04±5.76)分,显著低于对照组的(35.29±6.35)分(P<0.05)。结论 CO_2激光微创术对血管性声带炎患者声带振动规律性有显著改善作用,配合保守药物与发音干预可以改善患者主客观声学指标,有利于嗓音功能恢复。Objective To assess the clinical curative effect of CO2 laser minimally invasive surgery and conservative drugs combined with pronunciation intervention in the treatment of vascular chorditis.Methods One hundred and two patients with vascular chorditis who were admitted to the hospital from January2016 to June2017 were selected as the subjects.They were divided into the treatment group and the control group by the random number table,51 patients in each group.The control group was treated with conservative drugs combined with pronunciation intervention,while the treatment group was treated by CO2 laser minimally invasive surgery based on the control group.The voice and acoustic indexes were compared between the two groups after 30 days of treatment,and the abnormal rate of laryngostroboscopic findings were analyzed.The voice handicap index（VHI）was evaluated.Results The Jitter and Shimmer in the treatment group were significantly lower than those in the control group after 30 days of treatment[（0.30±0.07）%and（1.89±0.42）% vs（0.35±0.08）% and（2.14±0.47）%]（P〈0.05）,and the harmonic to noise ratio（HNR）was significantly higher than that in the control group[（23.12±3.47）dB]（21.65±3.25）dB]（P〈0.05）.The abnormal rates of symmetry and periodicity in the treatment group were significantly lower than those in the control group after 30 days of treatment（41.2% and 27.5% vs 60.8% and 51.0%）（P〈0.05）.The total score of VHI in the treatment group was significantly lower than that in the control group after 30 days of treatment[（32.04±5.76）points vs（35.29±6.35）points]（P〈0.05）.Conclusion CO2 laser minimally invasive surgery can significantly improve the regularity of vocal cord vibration in patients with chorditis.And It can improve subjective and objective acoustic indexes combined with conservative drug and pronunciation intervention,which is conducive to voice function recovery.

关 键 词：血管性声带炎 CO2激光 嗓音声学 频闪喉镜 嗓音障碍指数 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]