早期声门型喉癌低温等离子射频术后喉肉芽肿的药物治疗  

Drug treatment of laryngeal granuloma after hypothermic plasma radiofrequency surgery for early glottic carcinoma

作　　者：佘翠平[1] 张庆丰 刘得龙[1] 焦梦思 石玉琦 She Cuiping;Zhang Qingfeng;Liu Delong;Jiao Mengsi;Shi Yuqi(Department of Otolaryngology,Dalian Municipal Central Hospital,Dalian 116033,China;Department of Otolaryngology,General Hospital of Shenzhen University,Shenzhen 518005,China)

机构地区：[1]大连市中心医院耳鼻咽喉头颈外科,116033 [2]深圳大学总医院耳鼻咽喉头颈外科,518055

出　　处：《中国医师进修杂志》2021年第12期1091-1095,共5页Chinese Journal of Postgraduates of Medicine

基　　金：大连市科技创新基金项目资助(2019J13SN77)。

摘　　要：目的探讨应用药物治疗早期声门型喉癌低温等离子射频术后形成的喉肉芽肿的有效性。方法对2011年1月至2021年1月大连市中心医院收治289例早期声门型喉癌内镜支撑喉镜下等离子射频手术治疗后形成的32例喉肉芽肿患者按照随机数字表法分为两组,一组为药物直接治疗组16例,另一组为观察再治疗组16例。两组用药皆为葡萄糖酸锌片剂(每片剂量70 mg,含锌10 mg)口服治疗,每次3片,每日2次。肉芽位于声带突者另加艾司奥美拉唑20 mg,每日2次,空腹口服。总疗程6~12周。结果随诊复查电子喉镜,肉芽肿的形成时间均在术后2~4个月,其中观察再治疗组的16例患者观察随诊3个月肉芽无明显变化,之后再进行药物治疗,发现两组患者药物治疗后的反应相似,均在治疗3周后肉芽开始变小,治疗6~12周肉芽均消失而停药,肉芽无再发,治愈率100%(32/32)。有2例患者葡萄糖酸锌片剂口服治疗3周后出现恶心,上腹部不适,减量用药后不适消失。结论早期声门型喉癌低温等离子射频术后出现的喉肉芽肿,单独给予葡萄糖酸锌片剂或者联合艾司奥美拉唑口服是一种有效、安全、复发率低的治疗方法。Objective to investigate the efficacy of drugs in the treatment of laryngeal granuloma after hypothermic plasma radiofrequency surgery in early glottic carcinoma.Methods Thirty-two cases of laryngeal granulomacoming from 289 patients with early glottic carcinoma treated by plasma radiofrequency surgery under endoscope-supported laryngoscopefrom January 2011 to January 2021 in Dalian Municipal Central Hospital were enrolled.All patients were given oral treatment of zinc gluconate tablets(70 grams per tablet,containing 10 grams of zinc).The usage was 3 tablets each time,twice a day.If the granulation was located in the vocal cord,20 mg of esomeprazolec was added twice a day,and taken orally on an empty stomach.The total course of treatment was 6-12 weeks.Results Follow-up and reexamination of electronic laryngoscope showed that the granulation of all patients began to become smaller after 3 weeks of drug treatment and gradually disappeared after 6-12 weeks.After the granulation disappeared,the drug was stopped,and there was no recurrence.Two patients developed nausea and epigastric discomfort after oral administration of zinc gluconate tablets for 3 weeks,and the discomfort disappeared after reducing the dose.Conclusions Oral administration of zinc gluconate tablets alone or in combination with esomeprazoleis an effective,safe and low recurrence method for laryngeal granuloma after hypothermic plasma radiofrequency ablation in early glottic carcinoma.

关 键 词：喉肿瘤 肉芽肿 喉 等离子射频 药物治疗 锌剂 

分 类 号：R739.65[医药卫生—肿瘤]