内镜下双侧声带后端切断术治疗双侧声带的效果及Logistic分析  

Effect and logistic analysis of endoscopic bilateral posterior vocal cord transection in the treatment of bilateral vocal cords

作　　者：王嘉麟 林佳怡 周幸强[1] 黄岸坤[1] 徐志坚[1] WANG Jialin;LIN Jiayi;ZHOU Xingqiang;HUANG Ankun;XU Zhijian(Department of Otolaryngology Head and Neck Surgery,Huizhou Central People's Hospital,Huizhou 516001,Guangdong,China)

机构地区：[1]惠州市中心人民医院耳鼻咽喉头颈外科,广东惠州516001

出　　处：《西部医学》2023年第1期92-96,共5页Medical Journal of West China

基　　金：惠州市科技计划项目(1705121817410149)。

摘　　要：目的研究内镜下双侧声带后端切断术对双侧声带麻痹所致上气道阻塞患者的手术效果。方法将本院2017年1月~2021年10月收治的83例双侧声带麻痹所致上气道阻塞患者纳入研究。将其根据电脑随机数字表法分作观察组41例和对照组42例。对照组开展传统术式治疗,观察组则开展内镜下双侧声带后端切断术治疗。分析两组一次性成功拔除气管套管率、气道重建成功率,手术前后吞咽功能变化情况,术后并发症发生情况,术后发音满意率等方面的差异。此外,采用Logistic分析法明确双侧声带麻痹所致上气道阻塞患者术后预后不良的影响因素。结果观察组一次性成功拔除气管套管率、气道重建成功率分别为75.61%、90.24%,均明显高于对照组的53.66%、69.05%(均P<0.05)。手术后观察组及对照组的Pearson评分分别为(0.32±0.02)分、(0.86±0.07)分,均明显低于手术前的(2.12±0.33)分、(2.13±0.32)分,且观察组明显低于对照组(均P<0.05)。观察组术后发音满意率评价高于对照组(P<0.05)。经Logistic分析法可得:未实施内镜下双侧声带后端切断术、年龄以及术后并发症均是双侧声带麻痹所致上气道阻塞患者术后预后不良的危险因素(均P<0.05)。结论内镜下双侧声带后端切断术对双侧声带麻痹所致上气道阻塞患者的手术效果显著,有利于促进患者吞咽功能及发音的恢复,值得临床推广应用。Objective To study the surgical effect of endoscopic bilateral posterior vocal cord amputation for upper airway obstruction caused by bilateral vocal cord paralysis.Methods From January 2017~October 2021,83 patients with upper airway obstruction caused by bilateral vocal cord paralysis were included in this study.The patients were divided into observation group of 41 cases and control group of 42 cases according to computer random number table.The control group received traditional surgical treatment,and the observation group received bilateral posterior vocal cord resection under endoscope.The two groups were analyzed the difference in terms of one-time successful tracheal cannula removal rate,success rate of airway reconstruction,changes in swallowing function before and after surgery,postoperative complications,postoperative pronunciation satisfaction rate and other aspects.In addition,Logistic analysis was used to determine the influencing factors of poor postoperative prognosis in patients with upper airway obstruction caused by bilateral vocal cord paralysis.Results The successful rate of tracheal cannula removal and airway reconstruction in observation group were 75.61%and 90.24%,which were significantly higher than those in control group of 53.66%and 69.05%(all P<0.05).After surgery,the Pearson scores of the observation group and the control group were(0.32±0.02)points and(0.86±0.07)points,which were significantly lower than the(2.12±0.33)points and(2.13±0.32)points before surgery,and the observation group was significantly lower than control group(all P<0.05).The evaluation of postoperative pronunciation satisfaction rate in observation group was higher than control group(P<0.05).Logistic analysis showed that failure to perform bilateral posterior vocal cord resection under endoscopy,age and postoperative complications were all risk factors for poor postoperative prognosis of patients with upper airway obstruction caused by bilateral vocal cord paralysis(all P<0.05).Conclusion Bilateral endoscopic po

关 键 词：双侧声带麻痹 上气道堵塞 双侧声带后端切断术 内镜 手术效果 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]