低温等离子联合CO_(2)激光手术治疗早期声门型喉癌的疗效分析  

Clinical Analysis on Joint Effect of Cryogenic Plasma and CO2 Laser on Early Glottic Laryngeal Carcinoma

作　　者：杨吉[1] 朱鑫[2] 刘定荣[1] 史余勇 丁大雄 张震 程瑶 邓启成 张西 YANG Ji;ZHU Xin;LIU Dingrong;SHI Yuyong;DING Daxiong;ZHANG Zhen;CHENG Yao;DENG Qicheng;ZHANG Xi(Department of Otorhinolaryngology Head and Neck Surgery,the 2nd People’s Hospital of Neijiang,Neijiang 641000,China;Department of Otorhinolaryngology Head and Neck Surgery,Affiliated Hospital of North Sichuan Medical College)

机构地区：[1]内江市第二人民医院耳鼻喉头颈外科,内江市641000 [2]川北医学院附属医院耳鼻喉头颈外科

出　　处：《中国激光医学杂志》2023年第5期241-246,共6页Chinese Journal of Laser Medicine & Surgery

基　　金：2019年南充市校科技战略合作项目(19SXHZ0072)。

摘　　要：目的探讨早期声门型喉癌治疗中低温等离子与CO_(2)激光联合应用模式下的疗效与优缺点。方法选择2016年3月至2020年3月,Tis-T2期声门型喉癌患者135例,按照治疗方法不同分为研究组和对照组,研究组患者72例采用经口支撑喉镜低温等离子联合CO_(2)激光手术;对照组患者63例,采用颈外开放手术。记录两组手术时间、出血量、卧床与禁食情况、术后并发症、复发及生存预后等情况。采用Kaplan-Meier进行生存分析。结果研究组患者在手术时间、出血量、卧床时间、禁食时间、围手术期活动出血、术后呼吸情况、稳定期发音情况等均较对照组有明显优势,但研究组喉粘连发生率明显高于对照组(P<0.05),研究组复发和死亡情况与对照组比较差异无统计学意义(P>0.05)。Kaplan-Meier进行生存分析亦显示两组手术模式患者生存预后差异无统计学意义(P>0.05)。结论经口显微镜下低温等离子联合CO_(2)激光治疗早期声门型喉癌,具有创伤小、恢复快、并发症少及喉功能保护好等优势,同时保持较低的复发与死亡率,值得临床推广应用。Objective To explore the efficacy,advantages and disadvantages of the combination of low temperature plasma and CO2 laser in treating early glottic laryngeal carcinoma.Methods The patients given surgical treatment of early glottic laryngeal cancer were divided into two groups by treating methods:the study group(transoral supported laryngoscope low-temperature plasma plus CO2 laser surgery)and control group(extra-cervical open surgery).The operation time,blood loss,bed rest and fasting situations,postoperative complications,recurrence and survival prognosis of the patients in each group were recorded in detail.Finally,clinical data were collected to analyze the differences between the two groups with Chi-square tests and t-tests,and kaplan-Meier survival analysis was performed.Results Compared with those in the control group,the patients in the study group showed obvious advantages in operation time,blood loss,bed time,fasting time,perioperative bleeding,postoperative respiratory conditions and stability of pronunciation,except an obviously higher incidence of throat conglutination(P<0.05).The difference between the two groups was not significant in the inci⁃dence of recurrence or in the incidence of death(P>0.05).Conclusions In the treatment of early glottic laryngeal cancer,the combination of low temperature plasma and CO2 laser under oral microscope has the advantages of less trauma,rapid recovery,less complications and better laryngeal function protection while maintaining a low recurrence and mortality,for which it is worthy of clinical recommendation and application.

关 键 词：激光 声门型早期喉癌 等离子 手术 

分 类 号：R616.4[医药卫生—外科学] R739.65[医药卫生—临床医学]