CO<sub>2</sub>激光声带切除术联合低温等离子对早期声门型喉癌患者嗓音声带黏连的影响

doi:10.3969/j.issn.1006-6233.2023.07.022

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摘要 目的: 探讨CO₂激光声带切除术联合低温等离子对早期声门型喉癌(EGC)患者嗓音、声带黏连的影响。方法: 回顾性收集2019年3月至2022年6月期间本院收治的行手术治疗的72例EGC患者的临床资料,按照不同治疗方法分为观察组(n=42)和对照组(n=30)。对照组采用CO₂激光声带切除术治疗,观察组采用CO₂激光声带切除术联合低温等离子治疗。比较两组手术前后嗓音指标、近期疗效、生活质量得分及并发症发生率。结果: 手术后6个月,两组基频微扰、振幅微扰较手术前均下降,最长发声时间(MPT)较手术前均延长,与对照组比较,观察组术后基频微扰、振幅微扰、MPT均显著优于对照组,差异有统计学意义(1.15±0.49%vs1.36±0.31%,t=2.068,P=0.042,2.69±0.85%vs3.32±0.54%,t=3.573,P=0.001,15.69±1.84vs13.17±1.69,t=5.924,P=0.000)。与对照组比较,观察组总有效率显著升高,差异有统计学意义(95.24vs76.67,χ²=5.518,P<0.05)。手术后6个月,两组生活质量量表各项得分及总分较手术前均下降,且手术后与对照组比较,观察组生活质量量表各项得分及总分显著低于对照组,差异有统计学意义(4.31±1.28vs6.39±0.54,t=8.371,P=0.000,10.25±1.32vs11.39±1.07,t=3.901,P=0.000,7.11±0.94vs7.56±0.53,t=2.364,P=0.021,17.83±2.34vs20.62±1.71,t=5.552,P=0.000)。两组声带黏连、肉芽肿发生率和并发症总发生率比较,差异无统计学意义(P>0.05)。结论: CO₂激光联合低温等离子疗法治疗EGC可进一步提高临床疗效,改善嗓音质量和生活质量。

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关键词 ：早期声门型喉癌, CO₂激光声带切除术, 低温等离子, 声带黏连

Abstract：Objective: To investigate the effect of CO₂ laser vocal cord resection combined with low temperature plasma on voice and vocal cord adhesion in patients with early glottic carcinoma ( EGC ). Methods: The clinical data of 72 patients with EGC who underwent surgical treatment in our hospital from March 2019 to June 2022 were retrospectively collected.According to different treatment methods,they were divided into observation group ( n=42 ) and control group ( n=30 ).The control group was treated with CO₂ laser vocal cord resection,and the observation group was treated with CO₂ laser vocal cord resection combined with low temperature plasma.The voice index,short-term efficacy,quality of life score and complication rate before and after operation were compared between the two groups. Results: Six months after operation,the fundamental frequency perturbation and amplitude perturbation of the two groups were lower than those before operation,and the longest phonation time ( MPT ) was longer than that before operation.Compared with the control group,the fundamental frequency perturbation,amplitude perturbation and MPT of the observation group were significantly better than those of the control group.The difference was statistically significant (1.15±0.49% vs1.36±0.31%,t= 2.068,P= 0.042,2.69±0.85 % vs3.32±0.54 %,t=3.573,P=0.001,15.69±1.84vs13.17±1.69,t= 5.924,P=0.000).Compared with the control group,the total effective rate of the observation group was significantly higher,the difference was statistically significant (95.24vs76.67,χ²=5.518,P<0.05).Six months after operation,the scores and total scores of the quality of life scale in the two groups were lower than those before operation,and the scores and total scores of the quality of life scale in the observation group were significantly lower than those in the control group.The difference was statistically significant ( 4.31±1.28vs6.39±0.54,t= 8.371,P=0.000,10.25± 1.32vs11.39 ±1.07,t= 3.901,P= 0.000,7.11±0.94vs7.56±0.53,t= 2.364,P= 0.021,17.83±2.34vs20.62±1.71,t= 5.552,P=0.000).There was no significant difference in the incidence of vocal cord adhesion,granuloma and total incidence of complications between the two groups (P>0.05 ). Conclusion: CO₂ laser combined with low temperature plasma therapy for EGC can further improve the clinical efficacy,voice quality,and quality of life.

Key words： Early glottic carcinoma CO₂ laser vocal cord resection Low temperature plasma Vocal cord adhesion

基金资助:广东省自然科学基金项目,(编号:2016A030310167)

通讯作者: 段礼府

引用本文:

魏兴, 段礼府, 鄢斌成, 蒋宗玲, 吴红英, 胡一勇, 马仁强. CO₂激光声带切除术联合低温等离子对早期声门型喉癌患者嗓音声带黏连的影响[J]. 河北医学, 2023, 29(7): 1174-1177.
WEI Xing, DUAN Lifu, YAN Bincheng, et al. Effect of CO₂ Laser Vocal Cord Resection Combined with Low Temperature Plasma on Voice and Vocal Cord Adhesion in Patients with Early Glottic Carcinoma. HeBei Med, 2023, 29(7): 1174-1177.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.07.022 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I7/1174

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