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马兵良 任 刚 石玉叶 徐 珏.三种不同手术方式治疗Ⅰ/Ⅱ期声门型喉癌优势对比分析[J].中国现代医生,2021,59(30):81-84
三种不同手术方式治疗Ⅰ/Ⅱ期声门型喉癌优势对比分析
Comparative analysis of advantages of laryngeal fissure,CO2 laser and low temperature plasma radiofrequency ablation in treatment of stage Ⅰ/Ⅱglottic laryngeal carcinoma
  
DOI:
中文关键词:  Ⅰ/Ⅱ期声门型喉癌  喉裂开术  二氧化碳激光术  低温等离子射频消融术
英文关键词:Stage Ⅰ/Ⅱglottic laryngeal carcinoma  Laryngeal fissure  CO2 laser  Low temperature plasma radiofrequency ablation
基金项目:浙江省医药卫生科技计划项目(2018KY772);浙江省湖州市科技计划项目(2018GYB78)
作者单位
马兵良 任 刚 石玉叶 徐 珏 浙江省湖州市第一人民医院耳鼻咽喉科浙江湖州 313000 
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中文摘要:
      目的 比较喉裂开术、二氧化碳(CO2)激光术及低温等离子射频消融术治疗Ⅰ/Ⅱ期声门型喉癌优势。方法 回顾性分析2015 年4 月至2017 年4 月我院收治的102 例Ⅰ/Ⅱ期声门型喉癌患者临床资料。根据手术方式分为A 组、B 组、C 组,每组各34 例。A 组患者为常规喉裂开术治疗,B 组患者为CO2 激光术治疗,C 组患者为低温等离子射频消融术治疗。比较三组患者手术时间、术中出血量、住院时间、VAS 评分、吞咽功能、术后并发症、术后1 年与3 年累积生存率及语音功能。结果 与B 组、A 组相比,C 组术中出血量明显更少,手术和住院时间更短,VAS评分明显更低(C 组P<0.05);术后C 组患者的基频微扰、振幅微扰均明显低于B 组、A 组(C 组B 组>A 组),差异有统计学意义(P<0.05);C 组与B 组吞咽功能有效率明显高于A 组,差异有统计学意义(χ2=6.572,P=0.037);C 组患者术后并发症总发生率明显低于B 组、A 组,差异有统计学意义(χ2=9.459,P=0.009);三组患者术后1 年与3 年累积生存率比较,差异均无统计学意义(P>0.05)。结论 三种手术方式在治疗Ⅰ/Ⅱ期声门型喉癌方面各具有优势,术后累积生存率无明显差异。但低温等离子射频消融术能够有效缩短住院时间,降低术后并发症,其临床应用更加安全,临床应根据患者病情选取适当术式。
英文摘要:
      Objective To compare the advantages of laryngeal fissure,CO2 laser and low temperature plasma radiofrequency ablation in the treatment of stage Ⅰ/Ⅱglottic laryngeal carcinoma.Methods The clinical data of 102 patients with stage Ⅰ/Ⅱglottic laryngeal carcinoma who were admitted to our hospital from April 2015 to April 2017 were retrospectively analyzed.According to the surgical procedures in the data,the patients were divided into Group A,Group B and Group C,with 34 cases in each.Group A was treated with conventional laryngeal fissure;Group B was treated with CO2 laser;Group C was treated with low temperature plasma radiofrequency ablation.The operative times,intraoperative blood losses,lengths of hospital stay,VAS scores,swallowing functions,postoperative complications,cumulative survival rates 1-year and 3-year after surgery,and speech functions were compared among the three groups.Results Compared with Group B and Group A,the intraoperative blood loss was significantly less,the operation time and lengths of hospital stay were shorter,and VAS scoreswere lower in Group C(Group CP<0.05).Postoperative fundamental frequency perturbation and amplitude perturbation in Group C were significantly lower than those in Group B and Group A(Group C P<0.05).But the harmonic noise ratio was significantly higher than that in Group B and Group A(Group C>Group B>Group A),with significant difference(P<0.05).The effective rate of swallowing function in Group C and Group B were significantly higher than that in Group A,with significant difference(χ2=6.572,P=0.037).The total incidence of postoperative complications in Group C was significantly lower than that in Group B and Group A,with significant difference(χ2=9.459,P=0.009).No significant differences in the 1-year and 3-year cumulative survival rates were observed among the three groups(P>0.05).Conclusion Laryngeal fissure,CO2 laser and low temperature plasma radiofrequency ablation have their respective advantages in the treatment of stage Ⅰ/Ⅱglottic laryngeal carcinoma,and no significant difference in postoperative cumulative survival rate exists.However,low temperature plasma radiofrequency ablation can effectively shorten the length of hospital stay and reduce postoperative complications,and its clinical application is safer.Therefore,appropriate surgical procedures should be selected according to the actual conditions of patients.
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