声带广基息肉两种微创切除术式的比较研究

Comparative analysis of the clinical efficacy of two minimally invasive surgical methods in the treatment of the broad-based type of vocal cord polyps

目的比较两种声带广基息肉微创切除术式的优缺点。方法 2009年1月至2014年10月,选择单侧声带广基息肉手术患者,随机分为两组,A组为喉内镜下电动吸切器组,B组为显微镜下二氧化碳(carbon dioxide,CO2)激光组,每组各30例,并随访6个月。结果 B组术中出血及手术时间均少于A组,两组指标差异有显著性(P<0.05)。两种手术方式总疗效无明显差别,术后均无明显手术并发症。结论两种声带广基息肉微创切除术均能取得满意效果,但各有利弊。显微镜下CO2激光切除出血少,手术时间短,但患者选择有局限。喉内镜电动吸切器切除视野开阔,但出血相对较多,手术技术要求较高。

Objective To compare the advantages and disadvantages of two different surgical methods for broad-based type of vocal cord polyps. Method 60 patients with vocal polyps were randomly divided into two groups. In Group A,30 patients were treated by the ENT precision cutter combined with the application of laryngeal endoscopy. In Group B,30 patients were treated by CO2 laser combined with the application of microscope. The 60 patients were followed up for 6 months. Result Group B showed significantly less blood loss and shorter operation time than that group A（ P〈0. 05）. No complication was found in the 60 patients. The total effective rate of the two groups was not significantly difference. Conclusion Satisfactory results were achieved with all the two surgical methods for the broad-based type of vocal cord polyp with different advantages and disadvantages. CO2 laser and microscope shorten the operation time and decrease intraoperative blood loss comparing the ENT precision cutter,but the selection of patients have limitations. The ENT precision cutter and endoscopy provide a wider visual field and more extensive application,but it has a long learning curve and needs more practice.