CO_2激光喉显微手术治疗喉良性和喉癌前期病变的临床研究
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摘要
目的:观察CO_2激光喉显微手术和常规支撑喉镜下治疗喉良性和喉癌前期病变的临床疗效。方法:选择收治喉良性和喉癌前期病变42例,按照治疗方法的不同,随机分为激光组和普通组,比较2组不同。结果:术后随访3个月,2组病人疗效比较差异无统计学意义(P>0.05),激光组1例喉鳞状上皮不典型增生术后复发并有声带粘连行二次激光手术外,普通组2例喉鳞状上皮不典型增生术后复发,1例声带息肉病人术后有声带闭合不全,余术后病变清除彻底,喉功能保存良好,无严重并发症发生。结论:显微镜支撑喉镜下CO_2激光治疗声带息肉及喉癌前期病变疗效可靠,能较好地保留喉结构和功能,是治疗喉部疾病的重要手段,需根据具体情况选择合适手术方式。
Objective: To observe the clinical effects between the CO_2 laser microsurgery and traditional self-retaining laryngoscope in the treatment of throat benign and precancerous lesions. Methods: Forty-two patients with throat benign and precancerous lesions were divided into the CO_2 laser group and common group according to the treatment method,and the clinical effects between two groups were compared. Results: All patients were followed up for 3 months,and the difference of total effective rate between two groups was not statistically significant( P > 0. 05). One case with laryngeal squamous epithelial dysplasia complicated with vocal cord adhesion in CO_2 laser group recurred,and treated with laser microsurgery again. The postoperative recurrence in two cases with laryngeal squamous epithelial dysplasia,and incomplete closure of vocal cord in 1 case with vocal polyp were found in common group. For other cases,the lesions were completed removed,the throat function was good,and no serious complications occurred. Conclusions: The clinical effect of vocal polyp and precancerous lesions treated with CO_2 laser microsurgery is effective,which can preserve the laryngeal structure and function,is an important means in treating throat disease. The operation method is selected according to the parent's condition.
Objective: To observe the clinical effects between the CO_2 laser microsurgery and traditional self-retaining laryngoscope in the treatment of throat benign and precancerous lesions. Methods: Forty-two patients with throat benign and precancerous lesions were divided into the CO_2 laser group and common group according to the treatment method,and the clinical effects between two groups were compared. Results: All patients were followed up for 3 months,and the difference of total effective rate between two groups was not statistically significant( P > 0. 05). One case with laryngeal squamous epithelial dysplasia complicated with vocal cord adhesion in CO_2 laser group recurred,and treated with laser microsurgery again. The postoperative recurrence in two cases with laryngeal squamous epithelial dysplasia,and incomplete closure of vocal cord in 1 case with vocal polyp were found in common group. For other cases,the lesions were completed removed,the throat function was good,and no serious complications occurred. Conclusions: The clinical effect of vocal polyp and precancerous lesions treated with CO_2 laser microsurgery is effective,which can preserve the laryngeal structure and function,is an important means in treating throat disease. The operation method is selected according to the parent's condition.
引文
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[5]于志良,王卫卫,王明华.耳鼻喉综合动力系统切除会厌囊肿23例[J].山东大学耳鼻喉眼学报,2008,22(3):278.
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[7]杨琛.支撑喉镜下二氧化碳激光切除治疗声带息肉的疗效评估[J].中国内镜杂志,2016,22(7):18.
[2]王军,马莉,高刚,等.二氧化碳激光治疗会厌囊肿42例[J].山东大学耳鼻喉眼学报,2013,26(1):46.
[3]王光辉,牟虹,梁传余.CO2激光与纤维喉镜治疗声带息肉的疗效对比[J].山东大学基础医学院学报,2005,19(2):104.
[4]DIAZ-DE-CERIO P,PRECIADO J,SANTAOLALLA F,et al.Costminimisation and cost-effectiveness analysis comparing transoral CO2laser cordectomy,laryngofissure cordectomy and radiontherapy for the treatment of T1-2,N0,M0 glottic carcinoma[J].Eur Arch Otorhinolaryngol,2013,270(4):1181.
[5]于志良,王卫卫,王明华.耳鼻喉综合动力系统切除会厌囊肿23例[J].山东大学耳鼻喉眼学报,2008,22(3):278.
[6]BENNINGER MS.Microdissection or microspot CO2laser for limited vocal fold benign lesions:a prospective randomized tria[J].Laryngoscope,2000,110(92):1.
[7]杨琛.支撑喉镜下二氧化碳激光切除治疗声带息肉的疗效评估[J].中国内镜杂志,2016,22(7):18.