显微支撑喉镜下二氧化碳激光联合术后辅助治疗在早期声门型喉鳞状细胞癌患者中的效果及安全性评价  

Efficacy and safety of carbon dioxide laser under microsupport laryngoscope combined postoperative adjuvant therapy in patients with early laryngeal squamous cell carcinoma

作　　者：徐义策 王玮[1] 李泽文[1] 周洁[1] XU Yice;WANG Wei;LI Zewen;ZHOU Jie(Department of Otolaryngology,Xiaogan Central Hospital,Xiaogan 432000,Hubei,China)

机构地区：[1]孝感市中心医院耳鼻咽喉科,湖北孝感432000

出　　处：《癌症进展》2021年第22期2318-2320,2354,共4页Oncology Progress

摘　　要：目的观察显微支撑喉镜下二氧化碳(CO_(2))激光联合术后辅助治疗在早期声门型喉鳞状细胞癌患者中的效果,并评价其安全性。方法将66例早期声门型喉鳞状细胞癌患者根据治疗方式的不同分为对照组(n=30)和观察组(n=36),对照组采用传统手术联合术后辅助治疗,观察组采用显微支撑喉镜下CO_(2)激光联合术后辅助治疗。观察两组患者一般手术情况、术后嗓音声学指标、远期预后及并发症发生率。结果观察组患者手术时间和住院时间均明显短于对照组,术中出血量明显低于对照组,差异均有统计学意义(P﹤0.01)。术后1周和术后1个月,观察组患者基频微扰、振幅微扰和谐噪比(HNR)均明显低于对照组,差异有统计学意义(P﹤0.01)。观察组患者术后1个月黏膜恢复情况优于对照组,差异有统计学意义(P﹤0.05)。两组患者3年生存率和局部复发率比较,差异均无统计学意义(P﹥0.05)。观察组患者并发症总发生率为2.78%(1/36),低于对照组的23.33%(7/30),差异有统计学意义(P﹤0.05)。结论显微支撑喉镜下CO_(2)激光联合术后辅助治疗在早期声门型喉鳞状细胞癌患者中的效果较好,可改善患者的预后,且手术创伤较小,具有临床应用价值。Objective To observe the efficacy of carbon dioxide(CO_(2))laser under microsupport laryngoscope com-bined postoperative adjuvant therapy in patients with early laryngeal squamous cell carcinoma and evaluate the safety.Method A total of 66 patients with early laryngeal squamous cell carcinoma were divided into the control group(n=30,received traditional surgery combined postoperative adjuvant therapy)and observation group(n=36,received CO_(2) laser under microsupport laryngoscope combined postoperative adjuvant therapy)according to the treatment method.The gen-eral condition,postoperative acoustic indicators,long-term prognosis and incidence of complications of two groups were observed.Result The operation time and hospitalization time of observation group were significantly shorter than those of control group,the intraoperative blood loss of observation group was significantly less than that of control group,the differences were statistically significant(P<0.01).After surgery 1 week and 1 month,the levels of jitter,shimmer and har-monic noise ratio(HNR)in the observation group were significantly lower than those in the control group(P<0.01).The mucosal recovery of observation group was better than that of control group 1 month after surgery(P<0.05).There was no significant difference in 3-year survival rate and local recurrence rate between the two groups(P>0.05).The incidence of complications in the observation group was 2.78%,lower than that of the control group with 23.33%,the difference was statistically significant(P<0.05).Conclusion The effect of CO_(2) laser under microsupport laryngoscope combined with postoperative adjuvant therapy in patients with early glottic laryngeal squamous cell carcinoma is better,which can improve the prognosis of patients,and the surgical trauma is less,so it has clinical application value.

关 键 词：CO_(2)激光治疗 喉鳞状细胞癌 效果 

分 类 号：R739.65[医药卫生—肿瘤]