102例儿童声带结节的临床分析研究  

Clinical analysis of 102cases of pediatric vocal fold nodules

作　　者：倪禕华 陈文霞[1] 许政敏[1] NI Yihua;CHEN Wenxia;XU Zhengmin(Department of Otorhinolaryngology Head and Neck Surgery,Children's Hospital of Fudan University,Shanghai,201102,China)

机构地区：[1]复旦大学附属儿科医院耳鼻咽喉头颈外科,上海201102

出　　处：《临床耳鼻咽喉头颈外科杂志》2023年第12期943-947,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨声带结节对于患儿生活质量的影响,比较保守治疗(嗓音卫生教育)与喉显微手术治疗的疗效及其差异性。方法:回顾性分析2020年1月-2022年12月间在复旦大学附属儿科医院耳鼻咽喉头颈外科门诊及住院治疗的102例声带结节患儿的临床资料,依据年龄分为学龄前组(2~5岁,58例)和学龄组(6~12岁,44例),依据治疗方案分为保守治疗组(52例)和手术治疗组(50例)。采用儿童嗓音相关生活质量量表(pediatric voice-related quality of life, pVRQOL)评估声带结节对患儿生活质量的影响以及两种治疗方案的疗效。结果:声带结节1级、2级、3级的pVRQOL评分分别为91.58±8.17,78.87±12.49,72.50±12.08,1级和2级、2级和3级评分比较差异均有统计学意义(P<0.001),提示声带结节评级越高,患儿的pVRQOL评分越小;学龄组pVRQOL评分为69.83±11.11,学龄前组pVRQOL评分87.59±8.63,2组比较差异有统计学意义(P=0.042),声带结节对学龄组患儿pVRQOL评分影响较明显;保守治疗组治疗前后pVRQOL评分分别为83.99±12.66、87.26±9.58,差异有统计学意义(P=0.046);嗓音卫生教育等间接嗓音治疗能够改善患儿的pVRQOL评分,且对学龄患儿更有效(P<0.001)。喉显微手术治疗对患儿pVRQOL评分的提升更为明显。结论:声带结节评级越高,对患儿生活质量影响越大;声带结节对学龄组患儿的生活质量影响大于学龄前组患儿;嗓音卫生教育等能改善患儿的生活质量,在学龄组中较明显。喉显微手术相较嗓音卫生教育等,改善患儿pVRQOL评分的效果更为显著。若家属要求改善嗓音相关的生活质量,则建议采用喉显微手术治疗声带结节。由于本研究随访期仅为术后6个月,因此喉显微手术治疗儿童声带结节的短期疗效明确,但长期疗效有待进一步研究。Objective:To evaluate the impact of vocal fold nodules on the quality of life of children,and to compare the efficacy between conservative management(voice hygiene education,etc.)and laryngeal microsurgery.Methods:A retrospective study was performed on 102children with vocal fold nodules,who received treatment in Children's Hospital of Fudan University during the period from January 2020to December 2022.According to the regime,the patients were divided into conservative management group and surgical treatment group;Cases are divided into pre-school age group(2-5years old)and school-age group(6-12years old)based on age.The pediatric voice-related quality of life(pVRQOL)was used to evaluate the impact of vocal fold nodules on the quality of life of children and differences in efficacy between two treatment regimens.Results:The pVRQOL scores of vocal fold nodule grades 1,2,and 3were 91.58±8.17,78.87±12.49,72.50±12.08,respectively.There were statistical differences between grade 1and grade 2,and between grade 2and grade 3.There were statistical differences between grade 1grade 2,grade 2and grade 3(P<0.001),suggesting that the higher the rating of vocal cord nodules,the lower the pVRQOL score of patients was.The pVRQOL score of the school-age group was 69.83±11.11,which is lower than that of the preschool group(87.59±8.63),and the difference was statistically significant(P=0.042).Vocal fold nodules had a significant impact on the pVRQOL score of school-age children.In the conservative management group,the pVRQOL scores before and after treatment were 83.99±12.66and 87.26±9.58,respectively,and there was significant difference between the two groups(P=0.046).Indirect voice therapy such as voice hygiene education could improve children's pVRQOL scores and was more effective for school-age children(P<0.001).The microsurgical treatment had a more significant improvement in the pVRQOL score of children.Conclusion:The higher the rating of vocal fold nodules,the greater the impact on the quality of life of patients.Voc

关 键 词：声带结节 儿童 嗓音相关生活质量量表 手术 

分 类 号：R767[医药卫生—耳鼻咽喉科]