低温等离子射频技术在早期舌癌手术中的应用

Application of low temperature radiofrequency volumetric tissue reduction in patients with tongue cancer

目的评估低温等离子射频技术在早期舌癌手术中的应用疗效。方法回顾分析我科2009~2014年间使用低温等离子射频技术切除舌部肿瘤的11例早期舌癌患者和20例采用高频电刀治疗早期舌癌患者在术中瘤体切除出血量、术后舌部疼痛感、术后舌部创面出血发生率、肿瘤复发或淋巴结转移等方面进行统计分析。结果 11例低温等离子射频切除组患者术中平均出血量为(13.82±7.40)ml,术后疼痛感VAS评分分别为第1天3.8±1.3,第3天2.5±0.7,第5天1.8±0.6,术后舌体创面出血1例,术后随访1年以上1例出现淋巴结转移。采用高频电刀手术组的20例患者术中平均出血量为(40.55±12.03)ml;术后疼痛感VAS评分分别为第1天6.8±1.3,第3天4.4±1.1,第5天2.3±0.7;术后舌体创面出血1例;随访3例出现肿瘤颈部淋巴结转移。低温等离子射频手术组患者术中瘤体切除出血量、术后第1天、第3天舌部疼痛感明显低于高频电刀手术组,两种术式术后第5天舌部疼痛感无明显差异,术后舌体创面出血率、术后肿瘤淋巴结转移无明显差异。结论低温等离子射频术在早期舌癌手术的治疗中具有瘤体切除出血量少,术后舌部疼痛感轻,并发症少等优点。

[ABSTRACT]OBJECTIVETo evaluate the effectiveness of low temperature radiofrequency ablation on tongue cancer in early stage (<2 cm T1 stage) .METHODS High differentiated tongue squamous cell carcinoma(<2 cm T1 stage) were removed with radiofrequency ablation in 11 patients and with high-frequency electrotome in 20 patients from 2009 to 2014 in our hospital. All the patients underwent elective neck dissection(I,Ⅱ,Ⅲ regions). Intraoperative blood loss, VAS ratings of post-operative pain, post-operative bleeding rate and the recurrence rate of tongue cancer or lymph node metastasis were compared between the two groups.RESULTSIn the radiofrequency ablation group, the mean intraoperative blood loss was 13.82±7.40ml, the VAS ratings of post-operative pain were 3.8±1.3 (day 1), 2.5±0.7 (day 3) and 1.8±0.6(day 5), post-operation bleeding occurred in one case, and lymph node metastasis occurred in one case at 6 month after operation. In the high-frequency electrotome group, the mean intraoperative blood loss was 40.55±12.03ml, the VAS ratings of post-operative pain were 6.8±1.3(day 1), 4.4±1.1(day 3) and 2.3±0.7(day 5), post-operation bleeding occurred in one case, and lymph node metastasis occurred in 3 cases at 6 month to one year after operation. The intraoperative blood loss and post-operative pain in radiofrequency ablation group were significantly lower and less than that in the high-frequency electrotome group.CONCLUSIONRadiofrequency ablation is a promising method for early stage tongue cancer with less blood loss, invasiveness and complications.