CO_2激光切除术和喉部分切除术治疗早期喉癌的疗效观察

Efficacy of CO_2 Laser Resection and Partial Laryngectomy in Treatment of Early Laryngeal Carcinoma

目的:分析早期喉癌患者应用CO_2激光切除术与喉部分切除术治疗的差异。方法:选取2013年1月-2016年8月本院收治的早期喉癌患者60例为研究对象。按照随机数字表法将其分为甲组(n=30)、乙组(n=30)。甲组予以CO_2激光切除术治疗,乙组予以喉部分切除术治疗。比较两组手术情况、近期疗效、并发症、术后1个月的嗓音学指标、术后1年的生活质量和复发情况。结果:甲组手术时间、术后2 d视觉模拟疼痛评分法(VAS)评分、喉黏膜水肿时间、住院时间均显著优于乙组,比较差异均有统计学意义(P<0.05);甲组近期总有效率为96.7%,高于乙组的90.0%,但比较差异无统计学意义(P>0.05);甲组并发症发生率为3.33%,低于乙组的20.00%,比较差异有统计学意义(X^2=4.043 1,P=0.044 3);术后1个月,甲组基频(F0)、基频微扰(Jitter)、声压级(SPL)、最长发音时间(MPT)、嗓音障碍指数(DSI)均显著优于乙组,比较差异均有统计学意义(P<0.05);术后1年,两组各项生活质量评分及复发率比较,差异均无统计学意义(P>0.05)。结论:与喉部分切除术比较,早期喉癌患者应用CO_2激光切除术治疗的术后恢复较快,并发症较少,但术后近期及远期效果无明显差异,是一种值得临床进一步应用与推广的治疗方法。

Objective:To analyze the difference between CO2 laser resection and partial laryngectomy in patients with early Laryngeal carcinoma.Method:A total of 60 patients with early Laryngeal carcinoma from January 2013 to August 2016 in our hospital were selected.According to the random number table method,they were divided into group A(n=30)and group B(n=30).Group A was treated with CO2 laser resection and group B with partial laryngectomy.The operation,short-term effect,complications,the voice index after operation 1 month,the quality of life and recurrence after operation 1 year between two groups were compared.Result:The operation time,2 d visual analogue scale(VAS)score,postoperative laryngeal mucosal edema in time,hospitalization time in group A were significantly better than those of group B,the differences were statistically significant(P<0.05).The short-term total efficiency of group A was 96.7%,which was higher than 90.0%of group B,but the difference was not statistically significant(P>0.05).The complication rate of group A was 3.33%,which was lower than 20.00%of group B,the difference was statistically significant(x2=4.043 1,P=0.044 3).After operation 1 month,the fundamental frequency(F0),fundamental frequency perturbation(Jitter),sound pressure level(SPL),maximum phonation time(MPT),voice handicap index(DSI)in group A were significantly better than those of group B,the differences were statistically significant(P<0.05).After operation 1 year,the scores of quality of life and the rate of recurrence in two groups were compared,the differences were not statistically significant(P>0.05).Conclusion:Compared with partial laryngectomy,CO2 laser resection for early laryngeal carcinoma has faster postoperative recovery and fewer complications,but there is no obvious difference in the short-term and long-term effect,which is a kind of treatment method worthy of clinical application and promotion.