微创手术及传统手术治疗声门型早期喉癌及癌前病变的临床效果比较

Comparing of the Clinical Effect of Minimally Invasive Operation and Traditional Operation in Treatment of Early Glottic Carcinoma and Precancerous Lesions

目的比较微创低温等离子射频消融术与传统喉切开手术治疗方式在治疗声门型早期及癌前病变的治疗效果。方法将简阳市人民医院耳鼻喉科于2013年2月至2014年5月收治的早期喉癌(声门型)及癌前病变患者85例,根据随机数字表法分为低温等离子射频消融术组(M组)43例,传统喉切开治疗手术组(T组)42例,于术后1个月对患者进行电子喉镜复检。比较两组患者短期治疗效果及复发率,视觉模拟评分法(VAS)疼痛评估,及治疗满意度。结果 M组平均手术时间明显较T组平均手术时间短[(11.1±2.4)min比(108.9±13.8)min,P<0.05]。两组患者治疗后1、3、5 d VAS评分均逐渐下降,但均高于治疗前[M组:(3.24±1.03)分、(2.97±0.96)分、(1.03±0.38)分比(0.56±0.15)分;T组:(8.47±1.58)分、(8.02±2.64)分、(5.85±2.02)分比(0.57±0.13)分](P<0.05),M组的VAS评分低于T组(P<0.05)。1年后T组复发5例,M组复发1例。结论与传统喉切开手术治疗方式相比,微创低温等离子射频消融术具有手术时间短、术后恢复效果好、复发率低的优点,可显著提高患者生活质量。

Objective To compare curative effect of minimally invasive radiofrequency ablation with traditional open operation in the treatment of early laryngeal glottic type cancer and precancerous lesions . Methods A total of 85 early laryngeal glottic type cancer and precancerous lesions patients in department of ENT Jianyang People′s Hospital from Feb.2013 to May 2014 were divided into minimally invasive radiofre-quency ablation group （group M,43 cases）and traditional open operation group （group T,42 cases）, according to the random number table method.After one month the patients were reexamined with electronic laryngoscope.The short-term therapeutic efficacy and recurrence rate, VAS pain assessment, and the satis-faction of patients were observed.Results The average operation time of group T was significantly shorter than that in group M[（11.1 ±2.4） min vs （108.9 ±13.8） min,P 〈0.05];VAS pain assessment of 1 day, 3 days, 5 days in two groups after treatment was gradually decreased [M group：（3.24 ±1.03） scores,（2.97 ±0.96） scores,（1.03 ±0.38） scores vs （0.56 ±0.15） scores;T group：（8.47 ±1.58） scores,（8.02 ±2.64）scores,（5.85 ±2.02）scores vs （0.57 ±0.13）scores] （P〈0.05）, M group signif-icantly lower than T group.During the 1-year follow-up,there were 5 cases of recurrence in group T, 1 case in group M.Conclusion Compared with traditional operation in treatment of laryngeal,minimally invasive radiofrequency ablation treatment of early glottic precancerous lesions has shorter operation time ,better post-operative recovery,and lower recurrence rate,which can significantly improve the life quality of the patients .