喉部分切除术与氩气刀治疗早期喉癌的并发症比较研究

Comparative study of complications between throat partial resection and argon-knife in treating early laryngeal cancer

目的 比较垂直喉部分切除术与支撑喉内窥镜下氩气刀微创治疗早期声门型喉癌的并发症发生情况.方法 回顾性分析2008年1月至2013年5月该院收治的早期喉癌32例（声门型,T1～T2N0M0）,根据治疗方式的不同分为治疗组与对照组,治疗组14例为采用支撑喉内窥镜下氩气刀切除术的病例,对照组18例为采用传统喉垂直部分切除术的病例.两组病例均于出院后定期随访,观察记录切口感染、咽瘘、喉瘘、吸入性肺炎、肉芽增生、喉瘢痕狭窄、肿瘤复发等常见并发症的发生情况.结果 治疗组与对照组相比,切口感染、咽瘘、喉瘘、吸入性肺炎、肉芽增生、喉瘢痕狭窄等常见并发症发生率明显降低,其术后并发症发生率差异有统计学意义（χ^2 =4.48,P＜0.05）.肿瘤复发情况差异无统计学意义（χ^2=2.00,P＞0.05）.结论 支撑喉内窥镜下氩气刀切除术对早期喉癌的治疗较传统的垂直部分切除术具有损伤小、并发症少、恢复快的优点.

Objective To compare the complication occurrence situation of vertical partical laryngectomy with argon-knife minimally invasive therapy under self-retaining laryngoscope in the treatment of early glottic cancer. Methods A retrospective analysis was made on the clinical data in 32 cases with the early laryngeal cancer （glottic type,T1-T2NOM0） in our hospital from January 2008 to May 2013. The cases were divided into the treatment group and control group according to the different treatment methods. Fourteen cases in the treatment group adopted argon-knife resection under self-retaining laryngoscope. Eighteen cases in the control group accepted traditional vertical partical laryngectomy. The two groups were performed the regular follow-up after discharge. The occurrence situation of complication such as incision infection, pharyngeal fistula, laryngostomic fistula, aspiration pneumonia,proliferation of granulation, cicatricial stricture of larynx, tumor recurrence, etc. were observed and recorded. Results The incidence rates of common complications such as incision infection,pharyngeal fistula,laryngostomic fistula,aspiration pneumonia, proliferation of granulation and cicatricial stricture of larynx in the treatment group were significantly decreased compared with the control group, the differences between them were statistically significant （χ^2=4.48, P〈0.05）. But there was no statistically significant difference in the tumor recurrence （χ^2= 2.00, P〉0.05）. Conclusion Compared with traditional vertical partical laryngectomy,argon-knife resection under self-retaining laryngoscope in the treatment of early glottic cancer has the characteristics of less injury,few complications and rapid recovery.