鼻内镜联合支撑喉镜手术治疗声带息肉的临床效果及对患者嗓音功能的影响
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摘要
目的:探讨鼻内镜联合支撑喉镜手术治疗声带息肉的临床价值。方法:将94例声带息肉患者按随机数字表法分为对照组(47例)和观察组(47例)。对照组行单纯支撑喉镜手术,观察组行鼻内镜联合支撑喉镜手术,观察两组疗效、手术前后嗓音功能变化、并发症及复发情况。结果:观察组治疗总有效率为93.62%,与对照组(78.72%)比较,差异有统计学意义(P<0.05)。术前两组嗓音功能差异无统计学意义(P>0.05);观察组术后2周NNE、Jitter及Shimmer与同期对照组比较,差异有统计学意义(P<0.05)。观察组术后并发症发生率为8.51%,与对照组(25.53%)比较,差异有统计学意义(P<0.05)。术后6个月,观察组未见复发病例,对照组复发率为4.26%(P>0.05);术后12个月,观察组复发率为2.13%,与对照组(14.89%)比较,差异有统计学意义(P<0.05)。结论:鼻内镜联合支撑喉镜手术治疗声带息肉,疗效确切,可显著改善患者嗓音功能,且安全性高,复发率低,值得推广。
Objective:To explore the clinical value of nasal endoscope combined with supporting laryngoscope surgery in the treatment of polyps of vocal cord.Method:Ninety-four patients with vocal cord polyps were randomly divided into the control group(47 cases)and the observation group(47 cases).The patients in the control group were treated with simply supporting laryngoscope surgery while the patients in the observation group were treated with nasal endoscope combined with supporting laryngoscope.The therapeutic effects,voice function changes before and after operation,complications and recurrence of the two groups were observed.Result:The total effective rate was 93.62%in the observation group,compared to 78.72%in the control group,the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 8.51%,compared with 25.53%in the control group,the difference was statistically significant(P<0.05).Six months after operation,there was no recurrence in the observation group,but the recurrence rate in the control group was 4.26%.There was no significant difference between the two groups(P>0.05).12 months after operation,the recurrence rate of the observation group was 2.13%,compared with 14.89% of the control group,the difference was statistically significant(P<0.05).Conclusion:Nasal endoscope combined with supporting laryngoscope for vocal cord polyps has a definite effect and can significantly improve the voice function of patients with high safety and low recurrence rate,which is worthy of promotion.
Objective:To explore the clinical value of nasal endoscope combined with supporting laryngoscope surgery in the treatment of polyps of vocal cord.Method:Ninety-four patients with vocal cord polyps were randomly divided into the control group(47 cases)and the observation group(47 cases).The patients in the control group were treated with simply supporting laryngoscope surgery while the patients in the observation group were treated with nasal endoscope combined with supporting laryngoscope.The therapeutic effects,voice function changes before and after operation,complications and recurrence of the two groups were observed.Result:The total effective rate was 93.62%in the observation group,compared to 78.72%in the control group,the difference was statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 8.51%,compared with 25.53%in the control group,the difference was statistically significant(P<0.05).Six months after operation,there was no recurrence in the observation group,but the recurrence rate in the control group was 4.26%.There was no significant difference between the two groups(P>0.05).12 months after operation,the recurrence rate of the observation group was 2.13%,compared with 14.89% of the control group,the difference was statistically significant(P<0.05).Conclusion:Nasal endoscope combined with supporting laryngoscope for vocal cord polyps has a definite effect and can significantly improve the voice function of patients with high safety and low recurrence rate,which is worthy of promotion.
引文
[1]郭文俊,何霞,郝红丽,等.声带息肉诊断与治疗[J].国际耳鼻咽喉头颈外科杂志,2017,41(5):254-257.
[2]汪涛,马俊,方国军,等.支撑喉镜下不同手术方法治疗声带息肉疗效分析[J].中国中西医结合耳鼻咽喉科杂志,2015,23(1):48-50.
[3]中华医学会.临床技术操作规范(耳鼻咽喉-头颈外科分册)[M].北京:人民军医出版社,2009:115-116.
[4]中华医学会.临床诊疗指南(耳鼻咽喉头颈外科分册)[M].北京:人民卫生出版社,2009:248-249.
[5]刘波,周长华,熊虹全,等.不同内镜下手术治疗声带息肉110例疗效分析[J].实用临床医药杂志,2016,20(7):150-151.
[6]LEE D H,YOON T M,LEE J K,et al.Predictive factors of recurrence and malignant transformation in vocal cord leukoplakia[J].Eur Arch Otorhinolaryngol,2015,272:1-6.
[7]黄天宇.全麻支撑喉镜联合鼻内镜与单纯支撑喉镜下治疗声带息肉的疗效比较[J].中国医药科学,2014,4(19):203-205.
[8]马利娟,汤夏冰,魏新民,等.支撑喉镜联合鼻内镜与纤维喉镜下切除声带息肉临床对比分析[J].现代中西医结合杂志,2017,26(6):608-610.
[9]黄涛.30°鼻内镜下摘除支撑喉镜暴露困难的声带息肉体会[J].山西医药杂志,2018,47(8):912-913.
[10]周亚权.支撑喉镜联合鼻内镜治疗暴露困难的声带良性病变28例[J].江苏医药,2016,42(10):1195-1196.
[11]任颖川.30°鼻内镜辅助支撑喉镜切除暴露困难的前联合声带息肉疗效分析[J].中国眼耳鼻喉科杂志,2014,14(1):46-46.
[12]姜宇英,王珊,诸葛盼,等.早期声带息肉患者嗓音障碍调查与对策[J].中华全科医学,2015,13(10):1608-1610.
[13]林智强,吴铖林,毛海燕,等.嗓音学分析在声带息肉手术疗效评估中的应用[J].医学综述,2014,20(2):325-327.
[14]SAKTHIVEL P,RANIPATEL S,SINGH I,et al.Paradoxical vocal cord movement during sleep-A unique case with review of literature[J].Int J Pediatr Otorhinolaryngol,2015,79:1946-1948.
[15]陈涛,高亚娜.支撑喉镜鼻内镜和纤维喉镜下治疗声带息肉的疗效及安全性比较[J].蚌埠医学院学报,2018,43(3):358-359.
[2]汪涛,马俊,方国军,等.支撑喉镜下不同手术方法治疗声带息肉疗效分析[J].中国中西医结合耳鼻咽喉科杂志,2015,23(1):48-50.
[3]中华医学会.临床技术操作规范(耳鼻咽喉-头颈外科分册)[M].北京:人民军医出版社,2009:115-116.
[4]中华医学会.临床诊疗指南(耳鼻咽喉头颈外科分册)[M].北京:人民卫生出版社,2009:248-249.
[5]刘波,周长华,熊虹全,等.不同内镜下手术治疗声带息肉110例疗效分析[J].实用临床医药杂志,2016,20(7):150-151.
[6]LEE D H,YOON T M,LEE J K,et al.Predictive factors of recurrence and malignant transformation in vocal cord leukoplakia[J].Eur Arch Otorhinolaryngol,2015,272:1-6.
[7]黄天宇.全麻支撑喉镜联合鼻内镜与单纯支撑喉镜下治疗声带息肉的疗效比较[J].中国医药科学,2014,4(19):203-205.
[8]马利娟,汤夏冰,魏新民,等.支撑喉镜联合鼻内镜与纤维喉镜下切除声带息肉临床对比分析[J].现代中西医结合杂志,2017,26(6):608-610.
[9]黄涛.30°鼻内镜下摘除支撑喉镜暴露困难的声带息肉体会[J].山西医药杂志,2018,47(8):912-913.
[10]周亚权.支撑喉镜联合鼻内镜治疗暴露困难的声带良性病变28例[J].江苏医药,2016,42(10):1195-1196.
[11]任颖川.30°鼻内镜辅助支撑喉镜切除暴露困难的前联合声带息肉疗效分析[J].中国眼耳鼻喉科杂志,2014,14(1):46-46.
[12]姜宇英,王珊,诸葛盼,等.早期声带息肉患者嗓音障碍调查与对策[J].中华全科医学,2015,13(10):1608-1610.
[13]林智强,吴铖林,毛海燕,等.嗓音学分析在声带息肉手术疗效评估中的应用[J].医学综述,2014,20(2):325-327.
[14]SAKTHIVEL P,RANIPATEL S,SINGH I,et al.Paradoxical vocal cord movement during sleep-A unique case with review of literature[J].Int J Pediatr Otorhinolaryngol,2015,79:1946-1948.
[15]陈涛,高亚娜.支撑喉镜鼻内镜和纤维喉镜下治疗声带息肉的疗效及安全性比较[J].蚌埠医学院学报,2018,43(3):358-359.