摘要
目的：比较CO2激光与喉显微手术切除声带息肉和声带白斑的疗效。方法60例声带息肉患者随机分成两组，每组30例；30例声带白斑患者随机分成两组，每组15例。两类患者均一组采用支撑喉镜下显微手术（常规组），另一组采用支撑喉镜下CO2激光切除病变组织或粘膜剥脱术（激光组）。两组患者分别于术前、术后1周、1月及3月行频闪喉镜、电子喉镜检查，GRABS、VHI主观评分及客观嗓音分析。结果声带息肉患者术后1周激光组患者声带恢复情况略差于常规组，术后1～3个月，电子喉镜检查、频闪喉镜黏膜波观察及嗓音主客观分析，两组差异均无统计学意义。声带白斑患者术后1周激光组声带创面恢复略差于常规组，术后1～3个月，两组间电子喉镜检查、频闪喉镜黏膜波观察及主客观嗓音分析差异无统计学意义，术后随访1～4年，激光组复发率（6．67％，1／15）明显低于常规组（20％，3／15）。结论 CO2激光喉显微手术治疗声带息肉和声带白斑患者均疗效好，尤其是治疗声带白斑的远期疗效优于常规手术。
Objective To compare the efficacy of CO2 laser and conventional laryngeal microsurgery in the treatment of benign lesions of vocal cord （polyp of vocal cord） and precancerous lesions （leukoplakia of vocal cord） of patients. Methods A total of 60 patients with vocal cord polyps were selected, and randomly divided into two groups, each with 30 patients. Thirty patients with vocal cord leukoplakia were selected and randomly divided into two groups, each with 15 patients. One group was performed by cold instruments for lesion resection （conventional group）, the other by CO2 laser for removal of diseased tissue or mucosal ablative surgery （laser group）. Two groups of patients were examined by laryngostroboscope, electronic laryngoscopy, GRABS, VHI subjective ratings and objective voice analysis before operation and one week, one month and three months after operation. ResuIts The outcomes of those with vocal cord polyps in early recovery （1 week） laser group were slightly worse than the conventional group. In later recovery （1～3 months）, with electronic laryngoscopy inspection, laryngostroboscope mucosal wave observation, the analysis of subjective and objective data from the two groups showed no significantly differences. For patients with vocal cord leukoplakia in early recovery （1 week）, laser group slightly worse than the conventional group, in later recovery （1～3 months）, there were no obvious difference between the two groups in electronic laryngoscopy inspection, laryngostroboscope mucosal wave observation, the analysis of subjective and ob_jective data. Follow -up operations, the recurrence rates in laser group was significantly lower than conventional group. ConcIusion The treatment by CO2 laser can significantly improve their pronunciation quality for vocal cord polyps and vocal cord leukoplakia patients, it has a good therapeutic effect, especially the long-term effective of vo_cal cord leukoplakia is better than conventional operation.
出处
《听力学及言语疾病杂志》
CAS
CSCD
北大核心
2015年第1期40-44,共5页
Journal of Audiology and Speech Pathology
基金
浦东新区卫生系统重点学科群建设(PWZxq2014-09)
上海市卫生局科研项目(2013Y074)
上海市科委基金项目(14DZ 1942008)资助
关键词
声带息肉
声带白斑
CO2
激光
Vocal cord polyp
Vocal cord leukoplakia
CO2 laser
