43例早期喉癌临床治疗分析

Clinical Analysis of 23 Patients with Early Glottic Carcinoma

目的:探讨CO_2激光手术治疗早期声门型喉癌的临床效果。方法:对2006年12月～2009年2月我院耳鼻咽喉头颈外科采用支撑喉镜下CO_2激光手术治疗的早期声门型喉癌43例(T_1期)进行临床分析。结果:本组43例患者均无气管切开,全部顺利完成治疗,均未发生严重并发症。43例患者中40例获3年以上随访,失访3例以死亡计。其中31例半年一次按期复查,未见异常,7例经电话信访证实健在未复发,1例2年后复发,行垂直半喉切除;1例2年后死于心脏病。本组3年存活率为93.0%。本组39例行动态喉镜检查,声带缘及闭合情况得分,术后半年为:6分9例(23.1%);5分15例(38.6%);4分6例(10.3%);3分3例(7.7%);2分6例(10.3%)。术后1年为:6分11例(28.2%);5分19例(12.8%);4分7例(17.9%);3分2例(5.1%)。结论:CO_2激光手术治疗早期声门型喉癌损伤小,愈合快,远期疗效好,可较好保全喉发声功能。

Objective： To explore clinical effects of CO2 laser surgery of the early glottic carcinoma.Methods：To analyze 23 cases of the early glottic carcinoma （Stage T1）performed CO2 laser surgery under the laryngoscope in otolaryngology-head and neck surgery of our hospital from January 1998 to February 2009. Results：There was no tracheotomy among 23 patients, all successfully completed treatment, and no serious complications. Among 23 patients. 21 cases obtained follow-up of 3 years or above, 2 lost cases as death. 15 cases checked on schedule every half an year, no abnormality, 4 eases confirmed by phone were still living and in good health without reeurrence, 1 case of recurrence after 2 years, implemented vertical hemilaryngectomy ; 1 case died of a heart attack after 2 years, survival rate of 3 years was 91.3% 20 cases in the group implemented dynamic laryngoscope inspection, scoring of vocal cord margins and closing conditions of six months after operation was ： 5 cases of 6 pointsf25.0%L 7 cases of 5 points （35.0% J, 3 cases of 4 points（l 5.0%L 2 cases of 3 points（10.0%）, 3 cases of 2 points（l 5.0%） ; 1 year after operation： 6 cases of 6 points（30.0%）, 10 cases of 5 points（50.0%）, 3 cases of 4 points（~5.0%）, 1 case of 3 points（5.0%）.Conelusion ：CO2 laser surgery is used for the early glottic carcinoma, with little injury, healing fast, good long-term curative effect, can better preserve the laryngeal phonatory function.