CO_2激光喉镜显微手术治疗早期声门型喉癌的疗效分析

Analysis on Microsurgical Treatment of Early Glottic Carcinoma with CO_2 Laser Laryngoscope

目的:分析探讨CO_2激光喉镜显微手术治疗早期声门型喉癌的临床疗效。方法:选取2014年11月至2016年11月28例采用CO_2激光喉镜显微手术治疗的早期声门型喉癌患者为研究对象,作为观察组,同时选取2012年10月至2014年10月28例采用开放式喉部分切除术治疗的早期声门型喉癌患者作为对照组,对比分析两组患者治疗前后的生活质量评分(QOL)和血清血管内皮生长因子(VEGF)变化,同时对比两组患者不同TNM分期的局部复发率和生存率。结果:治疗前,两组患者QOL评分和VEGF水平相比无显著性差异(P>0.05),治疗后,对照组患者各指标分别为(33.68±4.97)分、(351.63±34.67)ng/L,观察组QOL评分和VEGF水平分别为(45.62±8.34)分、(204.81±32.24)ng/L,组间差异均具有统计学意义(t=16.416.51;P<0.05);观察组患者局部复发率显著低于对照组,生存率高于对照组,组间差异具有统计学意义(P<0.05)。结论:CO_2激光喉镜显微手术用于早期声门型喉癌患者的治疗有利于患者术后的生活质量,且术后复发率较低,安全性较高,值得临床推广。

Objective： To analyze the clinical effect of CO2 laser laryngoscope microsurgical treatment of early glottic laryngeal cancer. Methods： 28 cases of early glottic carcinoma with CO2 laser laryngoscopy treated in our hospital in November ~ 2016 November 2014 were selected as the observation group. Meanwhile,28 cases of early glottic laryngocarcinoma treated by open partial laryngectomy in our hospital in October October2012 to 2014 were selected as control group. The quality of life score（ QOL） and serum vascular endothelial growth factor（ VEGF） in two groups before and after treatment were compared and analyzed. Meanwhile,the local recurrence rate and survival rate of two groups of patients with different TNM staging were compared. Results： Before treatment,there was no significant difference between the two groups in QOL score and VEGF level（ P〉0.05）. After treatment,the indexes in the control group were [（ 25.6833.68 ± 6.354.97） points and（ 442.46351） respectively. 63 ± 36.0834.67 ng/L]. After treatment,the QOL score and VEGF level in the observation group were（ 45.62 ± 8.34） and（ 204.81 ± 32.24 ng/L,respectively]（ T =-13.71716.41,35.4186.51; P〈0.05）. The rate of local recurrence in the observation group was significantly lower than that in the control group,and the survival rate was higher than that of the control group,and the difference between the groups was statistically significant（ P〈0.05）. Conclusion： The use of CO2 laryngoscope microsurgery in the treatment of patients with early glottic laryngeal cancer is helpful to improve the quality of life of patients with low recurrence rate and high safety and is worthy of clinical promotion.