支撑喉镜下CO_2激光术治疗声门型喉癌的疗效观察  

Effect of CO_2 laser assisted laryngoscope on glottic carcinoma

作　　者：徐凌[1] 牛银花[1] 苏日格[1] 张姝[1] Xu Ling;Niu Yinhua;Su Rige;Zhang Shu(Department of Otolaryngology,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,China)

机构地区：[1]内蒙古医科大学附属医院耳鼻喉科,呼和浩特010050

出　　处：《中国医师杂志》2019年第2期215-219,共5页Journal of Chinese Physician

摘　　要：目的探讨支撑喉镜下CO_2激光术治疗早期声门型喉癌患者的疗效。方法选取本院97例早期声门型喉癌患者,按随机数字表法分成两组,对照组48例给予喉裂开喉部分切除术治疗,观察组49例实施支撑喉镜下CO_2激光术治疗,观察比较两组临床疗效、术后10 min血清α1-酸性糖蛋白(α1-AG)、铜蓝蛋白(CER)水平及嗓音功能各指标[基频微扰(Jitter)、最长发声时间(MPT)、声压级(SPL)]变化情况,并统计两组并发症发生率及生活质量(QOL)评分。结果观察组总缓解率为79. 59%(39/49),高于对照组56. 25%(27/48),差异有统计学意义(χ~2=6. 075,P=0. 014);术后10 min观察组血清α1-AG、CER水平均低于对照组,差异有统计学意义(t=2. 641,P=0. 010,t=31. 242,P=0. 000);术后2周至术后3个月两组SPL、MPT先降低后升高,Jitter先升高后降低,且观察组变化幅度小于对照组,差异有统计学意义(P <0. 05);观察组并发症发生率为2. 04%(1/49),低于对照组16. 67%(8/48),差异有统计学意义(P <0. 05);术后3个月观察组QOL评分高于对照组,差异有统计学意义(P <0. 05)。结论支撑喉镜下CO_2激光术可改善早期声门型喉癌患者应激状态及生活质量,且术后并发症发生率低,对嗓音功能影响小,疗效显著。Objective To prospectively investigate laryngoscopy-assisted CO2 laser in the treatment of glottic laryngeal carcinoma. Methods 97 patients with early glottic laryngeal carcinoma in our hospital were selected and divided into control group (n=48) and observation group (n=49) according to random number table. The control group was treated with partial laryngectomy and the observation group was treated with laryngoscopy-assisted CO2 laser. The clinical efficacy, serum level of α1-acid glycoprotein (α1-AG) and ceruloplasmin (CER) after 10 min of the surgery and changes of the indicators of voice function [fundamental frequency jitter (jitter), the longest sound time (MPT), sound pressure level (SPL)] were observed and compared between the two groups, and the incidence of complications and quality of life (QOL) scores were statistically compared. Results The total remission rate in the observation group was 79.59%(39/49), which was higher than that in the control group 56.25%(27/48), with statistically significant difference (χ2=6.075, P=0.014). The levels of serum α1-AG and CER in the observation group 10 min after surgery were lower than those in the control group, with statistically significant difference (t=2.641, P=0.010, t=31.242, P=0.000). From 2 weeks after surgery to 3 months after surgery, SPL and MPT of two groups decreased first and then increased;Jitter increased first and then decreased, and the changing amplitude in the observation group was smaller than that in the control group, with statistically significant difference (P<0.05). The incidence of complications in the observation group was 2.04%(1/49), which was lower than that in the control group 16.67%(8/48), with statistically significant difference (P<0.05);3 months after surgery, the QOL score of the observation group was higher than that of the control group, with statistically significant difference (P<0.05). Conclusions Supporting laryngoscope CO2 laser surgery can improve stress state and quality of life of early glottic laryngeal cancer

关 键 词：喉肿瘤 声门 喉镜检查 激光疗法 激光 气体 

分 类 号：R739.65[医药卫生—肿瘤]