探讨应用CO_2激光治疗早期声门型喉癌临床效果

Clinical effects of CO_2 laser on early glottic cancer

目的探讨应用CO_2激光治疗早期声门型喉癌的临床效果。方法选择2012年5月—2017年5月在我院耳鼻咽喉头颈外科行CO_2激光治疗的40例早期声门型喉癌患者临床资料进行总结分析。其中T1a病变24例、T1b病变9例、T2病变7例;未累及前联合34例、累及前联合6例。行CO_2激光治疗后随诊时间6~72个月。结果 40例患者术后5例(12.5%)复发;其中T1a病变患者复发率为4.2%(1/24),T1b病变患者复发率为11.1%(1/9),T2病变患者复发率42.9%(3/7),经卡方检验差异具有统计学意义(χ~2=7.4376,P=0.0243)。在未累及前联合的患者中,复发率为11.8%(4/34),累及前联合的患者中,复发率为16.7%(1/6),经卡方检验差异不具有统计学意义(χ~2=0.1120,P=0.7378)。在所有40例患者中,存活39例(97.5%),死亡1例(2.5%)。结论 CO_2激光治疗早期声门型喉癌能较好地保全喉功能,效果确切可靠,值得推广应用。

Objective To explore the clinical effects of CO2 laser for early glottic cancer.Methods The clinical data of 40 cases with early glottic cancer from May 2012 to May 2017 were selected,including 24 cases of T1a lesion,9 cases of T1b lesion,7 cases of T2 lesion,34 cases without involvement of glottis joint,and 6 cases with involvement of glottis joint.After CO2 laser,the cases were followed up for 6-72 months.Results In the 40 cases,5 cases(12.5%)recurred after surgery.The recurrence rates for T1a,T1b,and T2 lesion patients were 4.2%(1/24),11.1%(1/9),and 42.9%(3/7),respectively(χ2=7.4376,P=0.0243).For the patients without involvement of glottis joint,the recurrence rate was 11.8%(4/34).For the patients with involvement of glottis joint,the recurrence rate was 16.7%(1/6)(χ2=0.1120,P=0.737 8).In the 40 cases,39(97.5%)cases survived and 1 died(2.5%).Conclusion CO2 laser can preserve voice function of larynx with good results for early glottic cancer,thus deserving promotion.