以声带白斑为表现的急性喉炎临床特征分析

Clinical Characteristics of Acute Laryngitis Which Looks Like Vocal Fold Leukoplakia

目的探讨以声带白斑为表现的急性喉炎的临床特征及转归。方法回顾性分析41例以声带白斑为表现的急性喉炎患者的病史特点，比较保守治疗前后频闪喉镜下病变特点。结果患者病程为7N～30天，中位时间为30天。病因依次为上呼吸道感染（30例，73．1％）、特发性（7例，17．1％）、烟酒过多（2例，4．9％）、用声过度（2例，4．9％）。频闪喉镜下见37例（90．2％）为双侧声带病变、4例（9．8％）为单侧声带病变，表现为声带表面及边缘白色物，36例（87．8％）白色物局限于声带前中部，5例（12．2％）白色物累及声带全长；20例（48．8％）声带白色物可见溃疡样改变。41例患者中30例予雾化吸入和／或抑酸治疗，其余患者口服中成药或促排药物治疗。6例患者复查时病变明显改善，35例患者声带白色物最终完全消失，其中31例（75．6％）干2月内（含2月）消失，2月以上消失者4例（9．8％）。结论以声带白斑为表现的急性喉炎患者大部分有上呼吸道感染史；病变以双侧为主，部分可见溃疡样改变；经保守治疗1～2月内声带白斑消失或明显改善。

Objective To investigate the characteristics and outcome of acute laryngitis which looks like vocal fold leukoplakia.Mothods This study included 41 acute laryngitis patients, whose vocal folds＇ lesion looked like ＂vocal fold leukoplakia＂. Study the characteristics of the 41 patients, compare the changes of lesion in the strobscope before and after conservative treatment. Results The duration of 41 patients ranged from 7 days to 1 month, and the median time is 1 month. The etiologies included upper respiratory infection （73.1%）, idiopathic （17.1%）, excessive drinking and smoking （4.9%）, voice abuse （4.9%）. 37 patients （90.2%） had bilateral vocal fold lesions and 4 patients （9.8%） had unilateral lesions. The lesions in stroboscope looked like ＂vocal fold leukoplakia＂ and 36 patients＇ （87.8%） lesions were located at anteromedian area of vocal fold. Others＇ （12.2%） were on the whole membranous portion of the vocal folds.20 （48.8%） patients＇ vocal fold were ulcerated. 30 patients were treated by aerosol inhalation and 14 of them took antireflux agents. Others received treatment by Chinese herbs or drugs used for promoting the cleaning of secretion. 6 patients＇ lesions were improved obviously and 35 patients＇ ＂vocal fold leukoplakia＂ disappeared completely. 31（75.6%） patients had recovered during 2 months and 4（9.8%） patients after 2 months. Conclusion Most acute laryngitis patients whose vocal fold lesion looks like ＂vocal fold leukoplakia＂ have upper respiratory infection. Bilateral vocal fold lesions are common, and some are ulcerated. The ＂vocal fold leukoplakia＂ disappeared or improved obviously after conservative treatment of 1-2 months.