二氧化碳激光微创治疗早期声门型喉癌疗效分析

Carbon dioxide laser microsurgery for treating early glottic carcinoma

目的总结二氧化碳激光手术治疗声门型喉癌的临床治疗效果。方法对2002年4月至2008年4月安徽省立医院耳鼻咽喉头颈外科激光手术治疗的89例声门型喉癌进行临床分析。89例中T1a病变55例，T1b病变18例，T2病变16例，累及前联合者15例。术后随诊6—72个月。结果89例支撑喉镜下CO2激光术后10例局部复发，复发率为11．2％（10／89）。T1a复发率5．4％（3／55），T1b复发率16．6％（3／18），T2复发率25．0％（4／16），组间差异有显著性（χ^2=4．839，P〈0．05）。病变侵犯前联合复发率13．3％（2／15），病变未侵犯前联合复发率10．8％（8／74）．两组间差异无统计学意义（χ^2=0．696，P〉0．05）。89例激光手术治疗的患者，86例存活，死亡3例。结论二氧化碳激光手术治疗早期声门型喉癌疗效可靠，喉功能保全好，是一种值得推广的治疗方式。

Objective To define the oncologic efficacy of transoral endoscopic CO2 laser surgery in early glottic carcinoma. Method A retrospective study of 89 patients with glottic carcinoma （55T1a, 18T1b,and 16T2） treated from April 2002 to April 2008. Surgical treatment included endoscopic CO2 laser eordectomies according to the classification of the European Laryngologieal Society. Results Relapse were detected in 10 out of 89 cases of glottic laryngeal carcinoma after CO2 laser surgery. The recurrent rate was 11.2% （ 10/89 ） , Recurrent ratio of T1a, T1b, T2 were 5.40% （ 3/55 ） , 16.6% （ 3/18 ） , 25.0% （ 4/16 ） respectively, with significant differences among groups （ χ^2 = 4.839 ,P 〈 0.05 ）. The rate of local recurrence with anterior commissure involvement was13.3% （ 2/15 ） and was 10.8% （8/74） when this site was not compromised by the tumor, this difference was not statistically significant （χ^2 = 0. 696,P 〉 0.05 ）. Conclusion According to the present series, endoscopic CO2 laser surgery is an effective treatment for early glottic cancer.