喉内镜下等离子消融术治疗早期声门型喉癌的临床效果分析

Clinical effect of plasma radiofrequency ablation under laryngeal endoscopic on early glottic cancer

目的探讨经支撑喉镜内镜辅助下等离子消融术治疗早期声门型喉癌的临床效果。方法选取早期声门型喉癌患者80例,按照治疗方式不同分为观察组(40例)与对照组(40例)。对照组采用传统喉裂开声带切除术,观察组采用喉内镜下等离子消融术治疗,分析比较两组手术情况、并发症、随访3年复发和生存情况及术后嗓音恢复情况。结果观察组术中手术时间、出血量、住院时间、术后疼痛评分(VAS)均少于对照组(t分别=40.75、20.25、12.61、9.36,P均<0.05);两组术后肉芽增生发生率比较,差异无统计学意义(χ2=0.29,P>0.05);观察组术后12月的基频微扰、振幅微扰及谐噪比明显优于对照组,差异均有统计学意义(t分别=3.59、4.13、3.64,P均<0.05);两组术后12月基频比较,差异无统计学意义(t=0.41,P>0.05);两组3年生存率和复发率比较,差异均无统计学意义(χ2分别=0.35、0.21,P均>0.05)。结论经支撑喉镜内镜辅助下等离子消融术治疗早期喉癌疗效确切,较喉裂开术具有微创、高效、术后嗓音恢复好的优势。

Objective To investigate the clinical effect of plasma radiofrequency ablation under laryngeal endoscopic on early glottic cancer. Methods Totally 80 patients with early glottic cancer were selected and divided into observation group（40 cases） and control group（40 cases） according to the different treatment methods. The control group was treated with traditional laryngeal split vocal cord resection,and the observation group was treated with laryngeal endoscopic plasma ablation. The surgery parameters,complications,recurrence and survival rate of 3 years after following-up and voice recovery after operation were compared between the two groups. Results The operation time,amount of petechea,hospitalization time,postoperative VAS score of the observation group were significantly lower than those of the control group（t=40.75,20.25,12.61,9.36,P〈0.05）. The incidence of granulation hyperplasia after operation between two groups was not statistically different（χ2=0.29,P〈0.05）. After 12 months,the fundamental frequency perturbation,the perturbation amplitude and harmonic to noise ratio of the observation group were significantly better than the control group,the differences were statistically significant（t=3.59,4.13,3.64,P〈0.05）. While the fundamental frequencies between two groups were not statistically different（t=0.41,P〈0.05）. The 3 years survival rate and the recurrence rate between two groups were not statistically different（χ2=0.35,0.21,P〈0.05）. Conclusion Plasma radiofrequency ablation under laryngeal endoscopic is effective for treating early glottic cancer with the advantages of less trauma,high efficiency and better postoperative voice recovery.