早期声门型喉癌患者CO2激光术后声带粘连的相关因素分析

Analysis of Related Factors of the Postoperative Vocal Cord Adhsion in Co_2 Laser Surgery for Early Glottic Carcinoma

目的探讨早期声门型喉癌患者CO_2激光术后声带粘连的相关因素。方法回顾性分析51例行CO_2激光手术治疗的早期声门型喉癌患者的临床资料,对其中发生声带粘连者其声带粘连与手术类型、肿瘤T分期、前联合是否受侵犯和术后是否出现肉芽等因素的相关性进行分析。结果 51例患者中,术后发生声带粘连23例,占45.10%（23/51）,其中按手术分型：Ⅱ型1例（12.50%,1/8）,Ⅲ型2例（22.22%,2/9）,Ⅳ型6例（50%,6/12）,Ⅴ型14例（63.64%,14/22）,各型间差异有统计学意义（χ~2（校正）=9.17,P〈0.05）;按肿瘤T分期：T_（is）2例（14.29%,2/14）,T_（1a）12例（46.15%,12/26）,Tlb 3例（100%,3/3）,T_2 6例（75%,6/8）,不同分期间差异有统计学意义（χ~2（校正）=13.84,P〈0.05）;前联合受侵犯9例（56.25%,9/16）,前联合未侵犯14例（40%,14/35）,两者差异无统计学意义（χ~2=1.171,P〉0.05）;喉内高出声带表面肉芽25例（49.02%,25/51）,其中8例因单一肉芽因素导致声带粘连,占32%（8/25）。结论早期声门型喉癌患者CO_2激光手术后声带粘连与手术类型、肿瘤T分期及术后肉芽增生有关。

Objective To evaluate the factors related to the postoperative vocal cord adhesion in CO_2 laser surgery for the early glottic carcinoma.Methods Retrospective analysis of 51 cases of early glottic laryngeal carcinoma treated with CO_2 laser surgery were carried out.Correlation analysis for the vocal cord adhesion with types of surgery,T-stages of tumor,whether infiltrated to the anterior commissure and granulation.Results In these cases,reoccurred vocal coed adhesion were 23 cases,accounted for 45.10%.Among 23 cases type Ⅱ surgery adhesion occurred postoperatively on 1 case（12.50%）,type Ⅲ surgery 2 cases（22.22%）,type Ⅳ surgery 6 cases（50%）,and type Ⅴ surgery 14 cases（63.63%）.The difference between the groups was statistically significant（χ~2=9.17,P〈0.05）.According to carcinoma T-stages for the vocal cord adhesion,T_（is） were2 cases（14.29%）,T_（1a） 12 cases（46.15%）,T_（1b） 3 cases（100%）,T_2 6 cases（75%）,the difference between the groups was statistically significant（χ~2=13.84,P〈0.05）.Infiltrated to the anterior commissure were 9 cases（56.25%）,un infiltrated to the anteri or commissure were 14 cases（40%）,the difference between the groups was not statistically significant（χ~2=1.171,P〉0.05）.Vocal cord granulation was found in 25 cases,8 cases adhesions with the individual factors directly,accounted for 32%（8/25）.Conclusion The postoperative vocal cord adhesion in CO_2 laser surgery for early glottic carcinoma is related to the surgical types,tumorous T-stages and granulation tissue.