既往手术治疗对特发性喉接触性肉芽肿治疗的影响探讨  

The effect of surgical resection on the treatment of idiopathic laryngeal contact granuloma

作　　者：潘宇飞 李进让 聂倩 张冉[2] 邹世桢 PAN Yufei;LI Jinrang;NIE Qian;ZHANG Ran;ZOU Shizhen(The Second School of Clinical Medicine,Southern Medical University,Guangzhou,510515,China;Department of Pharyngology Laryngology&Phonosurgery Department of Otorhinolaryngology Head and Neck Surgery,the Sixth Medical Center of PLA General Hospital)

机构地区：[1]南方医科大学第二临床医学院,广州510515 [2]解放军总医院第六医学中心耳鼻咽喉头颈外科医学部咽喉嗓音外科

出　　处：《临床耳鼻咽喉头颈外科杂志》2022年第2期101-104,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨特发性喉接触性肉芽肿手术治疗史对其后续治疗的效果影响。方法:对2014年4月—2019年12月就诊于解放军总医院第六医学中心耳鼻咽喉头颈外科门诊,自愿选择经甲状舌骨膜病变内注射糖皮质激素联合口服奥美拉唑治疗的390例特发性喉接触性肉芽肿男性患者的临床资料进行回顾性分析,根据在接受联合疗法前,是否曾接受喉接触性肉芽肿显微切除术将患者分为有手术史组(172例)和无手术史组(218例),之后均接受联合疗法,比较两组的疗效和治愈时间。结果:截止联合治疗后第6个月时,有手术史组联合疗法的总有效率为71.5%(123/172),无手术史组总有效率为97.7%(213/218),两组差异有统计学意义(Z=-7.828,P=0.0001),并且无手术史组患者的平均治愈时间较有手术史组明显缩短(Z=-4.441,P=0.0001)。结论:因喉接触性肉芽肿的手术治疗增加了后续治疗的难度,因此不建议对初诊的喉接触性肉芽肿患者采取手术治疗。Objective: The aim of this study is to investigate the effect of surgical resection of idiopathic laryngeal contact granuloma on the follow-up treatment. Methods: From April 2014 to December 2019, the clinical data of 390 male patients with idiopathic laryngeal granuloma treated were analyzed retrospectively. The patients were divided into the group with history of surgical resection(172 patients) and the group without surgical resection history(218 patients), and then both received the combined therapy. The treatment efficacy of the two groups were compared. Results: By the end of 6 months after beginning the combined therapy, the total efficacy rate of the patients with a history of surgery was 71.5%(123/172), and that in patients without a history of surgery was 97.7%(213/218). The difference between the two groups was statistically significant(Z=-7.828, P=0.0001). Among the cured patients, the cure time of patients without the surgery history was shorter than patients with surgery history(Z=-4.441, P=0.0001). Conclusion: Surgical treatment of laryngeal contact granuloma increases the difficulty of follow-up treatment, so surgical treatment is not recommended for newly diagnosed patients with laryngeal contact granuloma.

关 键 词：喉接触性肉芽肿 糖皮质激素 质子泵抑制剂 

分 类 号：R767.1[医药卫生—耳鼻咽喉科]