支撑喉镜显微镜下CO_(2)激光会厌囊肿切除后黏膜缝合安全性及有效性研究  

Observation on the Curative Effect of CO_(2)Laser Epiglottic Cyst Resection and Mucosal Suture Under Laryngoscope Microscope

作　　者：杨磊[1] YANG Lei(Department of Otorhinolaryngology-Head and Neck Surgery,Xiamen Humanity Hospital Affiliated to Fujian Medical University,Xiamen 361001,China)

机构地区：[1]福建医科大学附属厦门弘爱医院耳鼻咽喉头颈外科,福建厦门361001

出　　处：《中国医药指南》2023年第33期26-29,共4页Guide of China Medicine

摘　　要：目的探讨支撑喉镜显微镜下CO_(2)激光切除会厌囊肿后对保留的会厌黏膜进行缝合与不缝合组安全性及有效性差异。方法将46例会厌囊肿患者随机分为两组,每组各23例。观察组实施显微镜支撑喉镜下CO_(2)激光会厌囊肿切除后黏膜缝合。对照组实施CO_(2)激光会厌囊肿切除后未缝合黏膜,比较两组手术的安全性和有效性。安全性指标为手术时间、出血量、肿胀情况、术后疼痛;有效性指标为术后吞咽功能、临床疗效、术后并发症。结果两组间出血量及第1天VAS疼痛评分无显著差异(P>0.05)。术后第3天、第7天观察组VAS疼痛评分低于对照组,差异具有统计学意义(P<0.05)。术后第7天,观察组肿胀评分低于对照组,差异具有统计学意义(P<0.05)。术后第3、7天,观察组吞咽筛查量表(EAT-10)评分低于对照组(P<0.05)。术后6个月两组临床疗效具有显著差异(P<0.05)。结论支撑喉镜显微镜下CO_(2)激光会厌囊肿切除后黏膜缝合较常规手术安全性及有效性显著提升,缝合黏膜,可加快创面肿胀消退,减轻术后疼痛,改善了患者术后吞咽功能,提高了患者术后的生活质量。Objective To investigate the safety and efficacy of suture and non-suture of retained epiglottic mucosa after CO_(2)laser resection of epiglottic cyst under laryngoscope microscope.Methods A total of 46 patients with epiglottic cyst were randomly divided into two groups,with 23 cases in each group.The observation group was treated with mucosal suture after CO_(2)laser epiglottic cyst resection under microscope.The control group was the unsutured group after CO_(2)laser epiglottic cyst resection.The safety and efficacy of the two groups were compared.The safety indicators were operation time,bleeding volume,swelling and postoperative pain.The effectiveness indicators were postoperative swallowing function,clinical efficacy and postoperative complications.Results There was no significant difference in blood loss and VAS pain score on the first day between the two groups(P>0.05).On the 3 rd and 7 th days after surgery,the VAS pain score in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The swelling score on the 7 th day in the observation group was significantly lower than that in the control group(P<0.05).On the 3 rd and 7 th day after operation,the score of EAT-10 in the observation group was lower than that in the control group(P<0.05).The clinical efficacy of the observation group was significantly different from that of the control group at 6 months after operation(P<0.05).Conclusions The safety and effectiveness of micro-suture technique after CO_(2)laser epiglottic cyst resection under suspension laryngoscope microscope are significantly improved compared with conventional surgery.Micro-suture technique will retain mucosal suture,accelerate wound swelling regression,reduce postoperative pain,improve postoperative swallowing function and improve postoperative quality of life.

关 键 词：会厌囊肿 显微缝合 支撑喉镜 CO_(2)激光 

分 类 号：R767.5[医药卫生—耳鼻咽喉科]