CO_2激光喉显微手术治疗喉癌前病变的疗效分析

The Efficacy Study of CO_2 Laser Treatment for Patients with Precancerous Laryngeal Lesions

目的探讨CO2激光喉显微手术治疗喉癌前病变的疗效。方法在显微支撑喉镜下,对94例喉癌前病变(喉角化症77例,成人喉乳头状瘤17例)患者,分别采用CO2激光黏膜表皮剥脱术、黏膜下切除术和声带部分切除术。结果对94例患者6个月～5年的随访显示,发声均恢复良好,一次性治愈率为86.2%(81/94);行两次或两次以上手术的有10例,占10.6%(10/94);最终癌变3例,其中喉角化症2例,成人乳头状瘤1例,占3.2%(3/94)。结论CO2激光喉显微手术治疗喉癌前病变,其疗效显著,具有创伤小、术后嗓音恢复快、不易复发等优点;且早期激光干预治疗可以打断癌前病变癌变的病理学基础,使其向良性转归方向发展。

Objective To evaluate the efficacy of CO2 laser treatment for patients with precancerous laryngeal lesions. Methods Ninety-four patients with precancerous laryngeal lesions were treated by endoscopic CO2 laser operation from 2001 to 2006. 87 males and 7 females patients had ages between 18 and 85. Results For a follow up ranging from 6 month to 5 years, the outcomes of 81 patients （81/94, 86.2%） were successful only through one operation while 10 cases （10/94,10.6%） received more than two operations. The lesions for 3 patients （3/94,3.2%） were found to have turned out malignant at a later stage. Conclusion The carbon dioxide laser has proved valuable in treating patients with precancerous laryngeal lesions.