CO2激光联合低温等离子治疗累及前联合早期声门型喉癌的远期预后及并发症观察  

Long-term prognosis and complications in patients with glottic laryngeal carcinoma involving the anterior commissure treated by CO2 laser combined with low-temperature plasma therapy

作　　者：章松林[1] 李建玲 刘杰[1] ZHANG Song-lin;LI Jian-ling;LIU Jie(Department of Otolaryngology,Baoji People's Hospital,Baoji 721000,China)

机构地区：[1]陕西宝鸡市人民医院耳鼻喉科

出　　处：《中国肿瘤临床与康复》2019年第11期1200-1203,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨CO2激光联合低温等离子治疗累及前联合早期声门型喉癌的远期预后及并发症发生情况。方法选取2013年1月至2014年5月间宝鸡市人民医院收治的64例累及前联合早期声门型喉癌患者,按照治疗方法不同分为CO2激光治疗组27例和联合治疗组37例。CO2激光治疗组采用CO2激光手术治疗,联合治疗组采用CO2激光联合低温等离子手术治疗,比较两组患者术后嗓音声学指标、并发症发生率、复发及生存率。结果随着术后时间的增长,两组患者基频微扰和振幅微扰逐渐降低,谐噪比逐渐升高,术后1周、1个月和3个月组内基频微扰、振幅微扰和谐噪比变化比较,差异均有统计学意义(P <0. 05)。联合治疗组患者振幅微扰在术后1周、1个月和3个月时较CO2激光治疗组低,谐噪比在术后3个月较CO2激光治疗组低,差异均有统计学意义(均P <0. 05)。联合治疗组患者复发率为5. 4%(2例),低于CO2激光治疗组的25. 9%(7例),差异有统计学意义(P <0. 05)。联合治疗组患者3年生存率为97. 3%(36例),高于CO2激光治疗组的81. 5%(22例),但差异无统计学意义(P> 0. 05)。联合治疗组患者5年生存率为91. 9%(34例),高于CO2激光治疗组的63. 0%(17例),差异有统计学意义(均P <0. 05)。联合治疗组患者术后并发症总发生率为16. 2%,低于对照组的44. 4%,差异有统计学意义(P <0. 05)。结论综上所述,CO2激光联合低温等离子治疗累及前联合早期声门型喉癌的远期预后较好,患者术后1个月嗓音恢复较好,且复发率和并发症发生率低,生存率高。Objective To investigate the long-term prognosis and complications in patients with glottic laryngeal carcinoma involving the anterior commissure treated by CO2 laser combined with low-temperature plasma therapy.Methods A total of 64 patients with glottic laryngeal carcinoma involving the anterior commissure who admitted to Baoji People’s Hospital from January 2013 to May 2014 were selected.The patients were divided into a CO2 laser treatment group(27 patients)and combination treatment group(37 patients)according to different treatment methods.CO2 laser treatment group received CO2 laser surgery and the combination treatment group received CO2 laser combined with low temperature plasma therapy.The acoustic characteristics of the voice,postoperative complication rate,recurrence and survival rates were compared between the two groups.Results Postoperative frequency perturbation and amplitude perturbation decreased and harmonic noise ratio(HNR)increased with time passing.There were significant differences in frequency perturbation,amplitude perturbation and HNR between the two groups at 1 week after the surgery and at 1 month and 3 months after the surgery(all P<0.05).Amplitude perturbation was lower in the combination treatment group than in the CO2 laser treatment group at 1 week after the surgery and at 1 month and 3 months after the surgery(all P<0.05).HNR was lower in the combination treatment group than in the CO2 laser treatment group at 3 months(P<0.05).The recurrence rate was 5.4%(2 patients)in the combination treatment group,which was significantly lower than 25.9%of the CO2 laser treatment group(7 patients).The 3-year survival rate was 97.3%(36 patients)in the combination treatment group,which was higher than 81.5%in the CO2 laser treatment group(22 patients),but the difference was not statistically significant(P>0.05).The 5-year survival rate was 91.9%(34 patients)in the combination treatment group,which was significantly higher than 60.3%of the CO2 laser treatment group(all P<0.05).The incidence of co

关 键 词：CO2激光 低温等离子 前联合 声门型喉癌 远期预后 并发症 

分 类 号：R739.65[医药卫生—肿瘤]