声门暴露困难患者不同手术方法对声带息肉切除、疼痛、嗓音质量及并发症的影响  

Effects of different surgical methods on vocal cord polyp removal,pain,voice quality,and complications in patients with glottis exposure difficulties

作　　者：孙宝珠 段广廷 许艳芳 SUN Bao-zhu;DUAN Guang-ting;XU Yan-fang(Department of Otolaryngology,Kaifeng Xiangfu District Hospital of Traditional Chinese Medicine,Kaifeng 475100,Henan,CHINA;Department of Otolaryngology,Kaifeng Central Hospital,Kaifeng 475000,Henan,CHINA)

机构地区：[1]开封市祥符区中医院耳鼻喉科,河南开封475100 [2]开封市中心医院耳鼻喉科,河南开封475000

出　　处：《海南医学》2024年第7期950-954,共5页Hainan Medical Journal

基　　金：2020年河南省医学科技攻关计划联合共建项目(编号:LHGJ20200838)。

摘　　要：目的探讨声门暴露困难患者不同手术方法对声带息肉(VCP)切除、疼痛、嗓音质量及并发症的影响。方法按随机数表法将2021年7月至2023年11月开封市祥符区中医院收治的110例VCP声门暴露困难患者分为观察组和对照组各55例。观察组患者予以支撑喉镜下会厌牵拉技术,对照组患者予以支撑喉镜联合鼻内镜手术。比较两组患者出院时的疗效,术后6 h、12 h、24 h、48 h的疼痛程度(VAS评分),围手术期指标,手术前后嗓音质量[振幅微扰值(shimmer)、噪声能量(NNE)、基频微扰值(Jitter)]及并发症发生情况。结果观察组患者的治疗总有效率为98.18%,略高于对照组的94.55%,但差异无统计学意义(P>0.05);术后6 h、12 h、24 h、48 h,观察组患者的VAS评分分别为(3.60±1.22)分、(4.05±1.34)分、(2.93±0.87)分、(1.80±0.59)分,与对照组的(3.71±1.08)分、(4.11±1.26)分、(2.89±0.92)分、(1.76±0.64)分比较差异均无统计学意义(P>0.05);观察组患者的声门暴露时间为(5.90±1.84)min,明显短于对照组的(3.87±1.22)min,差异有统计学意义(P<0.05),但两组患者的手术时间、首次发声时间、声音恢复时间、住院时间比较差异均无统计学意义(P>0.05);术后,两组患者的Jitter、shimmer、NNE比较差异也均无统计学意义(P>0.05);观察组患者的并发症总发生率为1.82%,略低于对照组的3.64%,但差异无统计学意义(P>0.05)。结论支撑喉镜下会厌牵拉技术与支撑喉镜联合鼻内镜手术是声门暴露困难VCP患者安全可靠的治疗方案,均能促进病情恢复,改善患者嗓音质量,而后者可明显降低声门暴露时间。Objective To investigate the effects of different surgical methods on vocal cord polyp(VCP)resection,pain,voice quality,and complications in patients with glottis exposure difficulties.Methods A total of 110 patients with VCP glottis exposure difficulties admitted toKaifeng Xiangfu District Hospital of Traditional Chinese Medicine from July 2021 to November 2023 were selected.They were divided into an observation group and a control group according to the random number table method,with 55 patients in each group.The patients in the observation group were given epiglottis traction technique under the laryngoscope,while the patients in the control group were given laryngoscope combined with endoscopic sinus surgery.The efficacy at discharge,the pain levels(VAS scores),and perioperative indicators at 6 h,12 h,24 h,and 48 h after surgery,as well as the voice quality[amplitude perturbation value(shimmer),normalized noise energy(NNE),fundamental frequency perturbation value(Jitter)],and complications before and after operation and complications were compared between the two groups.Results The total effective rate of treatment in the observation group was 98.18%,which was slightly higher than 94.55%in the control group(P>0.05).The VAS scores of patients at 6 h,12 h,24 h,and 48 h after surgery in the observation group were(3.60±1.22)points,(4.05±1.34)points,(2.93±0.87)points,and(1.80±0.59)points,respectively,which were not significantly different from(3.71±1.08)points,(4.11±1.26)points,(2.89±0.92)points,and(1.76±0.64)points in the control group(P>0.05).The glottis exposure time of patients in the observation group was(5.90±1.84)min,which was significantly shorter than(3.87±1.22)min in the control group(P<0.05).However,there were no significant differences in operation time,first sound time,voice recovery time,and length of hospital stay between the two groups(P>0.05).There was no significant difference in Jitter,shimmer,and NNE between the two groups after operation(P>0.05).The total incidence of complications

关 键 词：声带息肉 声门暴露困难 支撑喉镜 会厌牵拉技术 鼻内镜手术 疼痛程度 嗓音质量 并发症 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]