等离子点状激发射频消融技术在猪声带部分切除术中的应用研究  

Application of Radiofrequency Ablation with Plasma Spot Excitation in Partial Resection of Vocal Fold in Pig

作　　者：刘婕妤 肖旭平[2] 周恩[2] 李京鲲 肖禹 Liu Jieyu;Xiao Xuping;Zhou En;Li Jingkun;Xiao Yu(Health Management Center,People's Hospital of Hunan Provincial,Changsha,410005,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)健康管理中心,长沙410005 [2]湖南省人民医院(湖南师范大学附属第一医院)耳鼻咽喉头颈外科

出　　处：《听力学及言语疾病杂志》2024年第6期536-540,共5页Journal of Audiology and Speech Pathology

基　　金：湖南省卫生健康委员会一般指导课题(202107014091);长沙市科技局项目(kq2202442)。

摘　　要：目的建立猪声带损伤模型,分析比较CO_(2)激光手术及低温等离子点状激发射频消融术对猪声带的损伤范围及声带损伤后修复模式。方法15头猪(30侧声带),同一头猪的双侧声带分别为激光组和等离子组,分别用CO_(2)激光和低温等离子点状激发射频消融技术行声韧带下切除术,于术后第1天、术后第3、6、9、15周麻醉后各处死3头猪,取声带行HE染色,垂直测量两组声带水肿变性区深度和纤维组织厚度,比较两组术后声带损伤范围及声带修复过程。结果术后第1天激光组水肿变性区深度较等离子组更深(P<0.01),术后第3、6、9周两组间差异无统计学意义(P>0.05)。两种术式术后第3周水肿变性区深度均小于术后第1天,术后第6周小于术后第3周(P<0.05);而术后第9周与术后第6周差异无统计学意义(P>0.05)。术后第15周等离子组声带固有层纤维组织厚度较激光组更薄(P<0.01)。结论等离子点状激发射频消融技术对猪声带的损伤范围相对CO_(2)激光较小,术后修复情况两种手术方式无明显差异,而形成声带瘢痕时声带固有层的纤维组织厚度等离子组更薄。Objective A porcine vocal cord injury model was established to analyze and compare the damage range of porcine vocal cords and the repair process after vocal cord injury caused by CO_(2)laser surgery and radiofrequency ablation with plasma spot excitation technology.Methods Fifteen pigs,30 sides of vocal cords,were used in this study.The bilateral vocal cords of the same pig were divided into CO_(2)laser and radiofrequency coblation(RFC)groups respectively.CO_(2)laser and radiofrequency ablation with plasma spot excitation technology were used to perform ubligamental cordectomy.Three pigs were sacrificed after anesthesia on postoperative day 1 and postoperative 3,6,9,and 15 weeks.The vocal cords were harvested for HE staining.The depth of edema degeneration zone and the fibrous tissue thickness were measured vertically in the two groups,and the postoperative vocal cord damage range and vocal cord repair process were compared between the two groups.Results The depth of edema degeneration zone in the CO_(2)laser group was deeper than that in the RFC group at 1 day postoperatively(P<0.01).There was no significant difference in the depth of the edema degeneration zone between the two groups at the 3rd,6th,and 9th weeks after operation(P>0.05).The depth of the edema degeneration zone at 3rd weeks postoperatively was less than that at 1 day postoperatively,and at 6th weeks postoperatively was less than that at 3rd weeks postoperatively for both operation modes(P<0.05).There was no statistically significant difference between 9th weeks postoperatively and 6th weeks postoperatively(P>0.05).At the 15th week after operation,the fibrous tissue thickness of the vocal fold lamina propria in the RFC group was thinner than that in the CO_(2)laser group(P<0.01).Conclusion Radiofrequency ablation with plasma spot excitation technology causes less damage to porcine vocal fold than CO_(2)laser.There is no significant difference between the two operation modes in terms of postoperative repair process,while the fibrous tissue in the

关 键 词：低温等离子射频消融 点状激发 动物模型 喉部损伤修复 

分 类 号：R767.1[医药卫生—耳鼻咽喉科]