显微喉镜下二氧化碳激光治疗声带息肉的临床疗效对比研究  

A comparative study on the clinical effect of carbon dioxide laser in the treatment of vocal cord polyp under laryngoscope

作　　者：扎依尔江·提依甫江 玛依努尔·马合木提 庞晓凤 殷亚虎 裴新峰 

机构地区：[1]新疆伊犁哈萨克自治州友谊医院,新疆伊犁835000

出　　处：《中国医学文摘（耳鼻咽喉科学）》2019年第6期444-447,共4页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的通过比较显微喉镜下二氧化碳激光手术和常规喉显微手术治疗声带息肉的临床疗效和主客观嗓音疗效分析,为声带息肉的手术方式选择提供临床依据。方法对我院在2017年01月~2018年12月期间收治并符合纳入和排除标准的51例声带息肉患者为临床资料,按照手术方式将其分为观察组和对照组。观察组患者采用显微喉镜下二氧化碳激光治疗,对照组患者采用支撑喉镜下常规切除治疗。比较两组患者的手术时间、术中出血量、住院时间、手术并发症,术后一个月疗效及对术前术后嗓音进行主客观分析。结果观察组手术时间较对照组长,有统计学意义;观察组术中出血量较对照组少,有统计数意义;两组患者住院时间及不良反应发生率无统计学差异;两组患者术后一个月临床疗效无明显的统计学差异;两组患者术后一个月基频微扰(Jitter)、振幅微扰(Shimmer)、谐噪比(HNR)、主观听感知评估GRBAS的粗糙声(G)及嗓音障碍指数(VHI-10)无明显统计学差异(P<0.05)。结论显微喉镜下二氧化碳激光手术及常规喉显微两种支撑喉镜下声带息肉切除术均为有效治疗声带息肉的手术方法,患者的发音质量与术前比较均有明显的改善,总体有效率相似,显微喉镜下二氧化碳激光手术组有术中出血少的优势,而常规喉显微手术有手术时间短的优势。Objective The aim of this study was to establish the clinical reference for the curative effect of different type of laryngeal surgery by postoperative clinical effect and voice evaluation after CO2 laser surgery and conventional laryngeal microsurgery for vocal cord polyps.Methods 51 patients with vocal cord polyps admitted to our hospital from January 2017 to December 2018 were selected as the research objects.According to the method of treatment the patients were divided into observation group and control group.The patients in observation group with vocal cord polyps were treated by CO2 laser surgery,and the patients in control group were treated by conventional laryngeal microsurgery.The surgical and rehabilitation indexes(operation time,intraoperative blood loss,hospital stay,surgical complication),surgical efficacy one month postoperation,VHI-10 self-evaluation and vocal parameters before and after treatment[jitter,shimmer,normalized noise energy(NNE)],were compared between the two groups.Results The operation time in observation group was longer than those in control group(P>0.05),and the intraoperative blood loss was lower than that in control group(P<0.05),the hospital stay and surgical complication between the two groups had no significant difference(P>0.05),the total effective rate of treatment between the two groups had no significant difference(P>0.05).There were no significant differences in jitte,shimmer,NHR,G of GRBAS and VHI-10 between the two groups.Conclusions The CO2 laser surgery and the conventional laryngeal microsurgery for vocal polyp resection were the effective treatment for vocal cord polyps.The pronunciation qualities of the patients were significantly improved by the two types of surgery.There was not too much difference between the effects of two types of surgery.The intraoperative blood loss of the CO2 laser surgery is lower than that conventional laryngeal microsurgery,while the operation time is longer than that conventional laryngeal microsurgery.

关 键 词：声带息肉 显微喉镜下二氧化碳激光术 常规喉显微手术 嗓音声学分析 

分 类 号：R73[医药卫生—肿瘤]