二氧化碳激光联合等离子射频消融术对早期喉癌的治疗效果  

Effect of carbon dioxide laser combined with plasma radiofrequency ablation in the treatment of early laryngeal cancer

作　　者：王军旗[1] 芦二永[1] 崔哲卿 WANG Junqi;LU Eryong;CUI Zheqing(Department of Otolaryngology and Head and Neck Surgery,the First Affiliated Hospital of He’nan University of Science and Technology,Luoyang 471003,He’nan,China;Department of Otolaryngology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,He’nan,China)

机构地区：[1]河南科技大学第一附属医院耳鼻咽喉头颈外科,河南洛阳471003 [2]郑州大学第一附属医院耳鼻喉科,郑州4500520

出　　处：《癌症进展》2021年第9期927-930,962,共5页Oncology Progress

摘　　要：目的探讨二氧化碳(CO2)激光联合等离子射频消融术(PRA)对早期喉癌的治疗效果。方法根据治疗方案的不同将80例早期喉癌患者分为开放组(采用喉裂开术)和联合组(采用CO2激光联合PRA治疗),各40例。观察并比较两组患者的术后呼吸功能、吞咽功能、发音功能[基频微扰(J)、振幅微扰(S)、谐波噪声比(HNR)]恢复情况、围手术期指标(手术时间、术中出血量、术后疼痛情况、住院时间),以及手术前后的生化指标[血管内皮生长因子(VEGF)、基质金属蛋白酶9(MMP9)]水平。对两组患者治疗结束后实施为期1年的随访,比较两组患者的术后并发症发生率、术后1年生存率、术后1年喉功能保存率。结果联合组患者的术后呼吸功能、吞咽功能的恢复情况均优于开放组患者(P﹤0.05)。术后,联合组患者术后J、S、HNR改善情况均明显优于开放组患者(P﹤0.01)。联合组患者的手术时间、住院时间均明显短于开放组患者,术中出血量明显少于开放组患者,视觉模拟评分法(VAS)评分明显低于开放组患者(P﹤0.01)。术后,联合组患者的血清VEGF、MMP9水平均明显低于开放组患者(P﹤0.01)。两组患者的术后1年生存率比较,差异无统计学意义(P﹥0.05)。联合组患者的术后1年并发症发生率低于开放组患者,术后1年喉功能保存率高于开放组患者(P﹤0.05)。结论早期喉癌患者采用CO2激光联合PRA治疗能取得与开放手术相当的生存率,但CO2激光联合PRA的治疗方案可在一定程度上减少手术创伤,尽可能地保留患者的喉部功能,同时降低患者术后血清VEGF、MMP9水平及并发症发生率。Objective To investigate the effect of carbon dioxide(CO2)laser treatment combined with plasma radiofrequency ablation(PRA)in the treatment of early laryngeal carcinoma.Method A total of 80 patients with early laryngeal cancer were selected and divided into the open group(n=40,receiving laryngeal dehiscence)and combined group(n=40,receiving CO2 laser combined with PRA treatment)according to the treatment regimen.The recovery of postoperative respiratory function,swallowing function and pronunciation function[jitter(J),shimmer(S),harmonic to noise ratio(HNR)],the perioperative indicators(operation time,intraoperative blood loss,postoperative pain,time of hospital stay),and the levels of biochemical indicators[serum vascular endothelial growth factor(VEGF),matrix metalloproteinase 9(MMP9)]before and after the operation were observed and compared between the two groups.The two groups of patients were followed up for 1 year after the treatment,and the incidence of postoperative complications,1-year overall survival,and preservation rate of laryngeal function after 1 year were compared between the two groups.Result The postoperative respiratory function and swallowing function recovery of patients in the combined group were better than those in the open group(P<0.05).After operation,the improvement of postoperative J,S and HNR values in the combined group were significantly better than those in the open group,with statistical significance(P<0.01).The operation time and the hospital stay of the combined group were significantly shorter than those of the open group,the intraoperative blood loss and viscual analogue scale(VAS)score was significantly lower than that of the open group(P<0.01).After the operation,the serum VEGF and MMP9 levels of the combined group were significantly lower than those of the open group(P<0.01).There was no statistically significant difference in the 1-year survival rate between the two groups of patients(P>0.05).The 1-year postoperative complication rate of the combined group was lower than

关 键 词：喉癌 等离子射频消融术 二氧化碳 激光 血管内皮生长因子 基质金属蛋白酶9 

分 类 号：R739.65[医药卫生—肿瘤]