3种不同术式治疗累及前联合的早期声门型喉癌临床疗效分析  

The clinical efficacy analysis of three different surgical procedures for the treatment of early glottic laryngeal carcinoma involving the anterior commissure

作　　者：胡陈芮 胡煜[2] 汪涛[2] 代键 刘丛利 HU Chenrui;HU Yu;WANG Tao;DAI Jian;LIU Congli(Graduate School of Bengbu Medical University,Bengbu 233000,China;Department of Otolaryngology Head and Neck Surgery,Lu'an People's Hospital,Lu'an 237000,China)

机构地区：[1]蚌埠医科大学研究生院,安徽蚌埠233000 [2]六安市人民医院耳鼻咽喉头颈外科,安徽六安237000

出　　处：《安徽医学》2024年第5期565-569,共5页Anhui Medical Journal

基　　金：六安市科技计划项目(编号:2020laskt03)。

摘　　要：目的比较3种不同术式治疗累及前联合的早期声门型喉癌的临床疗效,为临床治疗术式的选择提供参考。方法回顾性分析2014年3月至2022年3月六安市人民医院耳鼻咽喉头颈外科收住的累及前联合的早期声门型喉癌患者76例,根据手术治疗方式的不同,分为等离子组(采用支撑喉镜显微镜下低温等离子喉部分切除术治疗,27例)、开放组(采用开放式喉部分切除术治疗,27例)和CO_(2)激光组(采用支撑喉镜显微镜下CO_(2)激光喉部分切除术治疗,22例)。比较3组手术相关指标、术后并发症及复发率差异。结果3组手术时间、术中出血量、术后住院时间及黏膜恢复评分比较,差异有统计学意义(P<0.05);两两比较显示,等离子组与开放组的差异、CO_(2)激光组与开放组的差异均有统计学意义(P<0.05),等离子组与CO_(2)激光组上述指标比较,差异均无统计学意义(P=0.581、0.482、0.647、0.198)。3组术后并发症发生率比较,差异无统计学意义(P=0.384)。开放组和等离子组术后复发率低于CO_(2)激光组,差异具有统计学意义(P=0.004、0.016)。结论对于累及前联合的早期声门型喉癌患者采用支撑喉镜显微镜下低温等离子喉部分切除术治疗,具有手术时间短、创伤小、术后恢复更快、复发率低的优势,是临床治疗中值得选择的一种术式。Objective To compare the clinical effectiveness of three distinct surgical approaches for managing early glottic laryngeal carcinoma extending into the anterior commissure so as to serve as a valuable reference for clinicians when choosing the most appropriate treatment method in clinical practice.Methods From March 2014 to March 2022,76 patients with early glottic laryngeal carcinoma involving the anterior commissure in the Department of Otorhinolaryngology,Head and Neck Surgery were retrospectively analyzed in Lu'an People's Hospital.These patients were categorized into the plasma group(treated with lowtemperature plasma laryngeal partial resection under supporting laryngoscopic microscope,27 cases),the open group(treated with open laryngeal partial resection,27 cases)and the CO_(2) laser group(treated with CO_(2) laser partial laryngectomy under supporting laryngoscope microscope,22 cases)according to different surgical treatments.A comparison was made among the three groups regarding operation-related indicators,postoperative complications,and recurrence rate.Results The three groups exhibited significant variances in terms of operation time,intraoperative blood loss,duration of postoperative hospital stay,and mucosal recovery score(P<0.05).There were significant differences between the plasma group and the open group(P<0.05),and between the CO_(2) laser group and the open group(P<0.05).There were no significant differences in the operation time,intraoperative blood loss,postoperative hospital stay and mucosal recovery score between the plasma group and the CO_(2) laser group(P=0.581,P=0.482,P=0.647,P=0.198).The occurrence of postoperative complications showedno significant variation among the three groups(P=0.384).However,the open group and the plasma group exhibited a lower postoperative recurrence rate than the CO_(2) laser group,with statistically significant differences(P=0.004,P=0.016).Conclusions For patients with early glottic laryngeal carcinoma involving the anterior commissure,low-temperature plasm

关 键 词：早期声门型喉癌 喉部分切除术 低温等离子射频消融术 激光 

分 类 号：R739.65[医药卫生—肿瘤]