CO_2激光联合平阳霉素治疗喉接触性肉芽肿的疗效分析

Clinical efficacy of CO_2 laser combined with pingyangmycin for laryngeal contact granuloma

目的:观察CO2激光联合平阳霉素的方法治疗喉接触性肉芽肿的临床疗效。方法:回顾性分析我院2011年1月至2012年12月确诊的18例喉接触性肉芽肿患者的临床资料。18例患者于我院共有22次治疗史。9例次采用CO2激光手术联合平阳霉素治疗,另13例次采用单纯CO2激光手术治疗,将所有病例根据治疗方法分为2组(CO2激光联合平阳霉素组与CO2激光组)。术后随访6个月以上。结果:CO2激光联合平阳霉素组1次手术治愈9例,治愈率为100.0%。CO2激光组1次手术治愈7例,6例术后复发,治愈率为53.8%,两者比较CO2激光联合平阳霉素1次治疗复发率低于单纯CO2激光手术(P<0.05)。结论:喉接触性肉芽肿有强烈的复发倾向,其发生和术后复发的原因可能是大量纤维细胞、血管增生,对于多次复发者,采用CO2激光联合平阳霉素的方法,可使血管闭塞,肉芽肿无法生长,明显降低复发率。

Objective：To observe the clinical efficacy of CO2 laser combined with pingyangmycin for laryngeal contact granuloma. Methods：Clinical data of 18 cases of laryngeal contact granuloma diagnosed from January 2011 to December 2012 in our hospital were retrospectively analyzed. All 18 patients had 22 times treatment history. Among them,9 patients were treated by CO2 laser operation combined with pingyangmycin（group 1） while 13 patients were treated by single CO2 laser operation（group 2）. All patients were followed up over 6 months after the operation. Results：The one-time curative rate was 100% in group 1 and was 53.8% in group 2. 7 cases were cured and 6 cases experienced recurrence. The relapse rate of CO2 laser operation combined with pingyangmycin was lower than that of single CO2 laser operation （P〈0.05）. Conclusion ：Laryngeal contact granuloma has a strong tendency to recur. The reason of occurrence and recurrence may relate with a large number of fiber cells and vascular proliferation. For recurrent patients, CO2 laser combined with pingyangmycin leads to vascular occlusion and granuloma growth inhibition ;therefore can significantly reduce the recurrence rate.