喉非特异性肉芽肿治疗方法的优先选择

Preferable treatment for nonspecific granuloma of larynx

目的探讨喉非特异性肉芽肿的综合治疗方式的优先选择及治疗效果。方法确诊为喉非特异性肉芽肿的患者20例,对8例有气管插管史者,未经任何保守治疗即行支撑喉镜下手术治疗,术后吸入类固醇2周;12例无气管插管史者,给予制酸药为主,支撑喉镜下手术、吸入类固醇、语音疗法为辅的治疗。结果所有患者治疗疗程结束后随访6个月,有气管插管史患者出现复发1例,经再次手术、术后吸入类固醇治疗后治愈;无气管插管史患者,10例仅经制酸治疗后症状完全消失,2例经同时配合予支撑喉镜下手术、吸入类固醇及语音疗法后治愈。结论喉非特异性肉芽肿病因复杂,治疗方法多样,对于有气管插管史者,优先选择手术及术后吸入类固醇治疗可缩短治疗时间,疗效显著;对于无气管插管史者,优先选择以制酸治疗为主的综合治疗,疗效显著。

Objective To explore the efficiency and effectiveness of comprehensive treatment for laryngeal nonspecific granuloma. Methods 20 patients with laryngeal nonspecific granuloma were enrolled. Among them, 8 patients with endotracheal intubation history were performed with self-retaining laryngoscope operation and 2-week corticosteroid in- halation without any other conservative treatment. 12 cases, without endotracheal intubation history, were administered chiefly with acid inhibitors combined with self-retaining laryngoscope operation, corticosteroids inhalation and phonolog- ical treatment. Results All the patients were followed up for 6 months after the treatments. Among the patients with endotracheal intubation history, one case recurred and was cured by surgery and corticosteroid inhalation. 10 cases of patients with Non-endotracheal intubation history were cured by acid suppression therapy only. 2 cases were cured by self-retaining laryngoscope operation combined with corticosteroid inhalation and phonological therapy. Conclusion The reason of laryngeal nonspecific granutoma is complicated and the treatment methods are various. For those with en- dotracheal intubation history, surgery and postoperative corticosteroids inhalation is preferable. For those without endo- tracheal intubation history acid ~nnnre.~ion thewnnv c^nmhlne^d with cw^mnr^h~n^ive~ tre, atme, nt i~ tho flrct c, hni,-,~