支撑喉镜治疗声带息肉的临床研究

Clinical study of vocal cord polyps treated with self-retaining laryngoscope

目的研究支撑喉镜治疗声带息肉(VCP)的临床效果。方法选择2015年7月~2017年6月于我院治疗的VCP患者118例,按照随机数字表法分为纤维喉镜组(n=59)与支撑喉镜组(n=59)。支撑喉镜组行支撑喉镜治疗,纤维喉镜组行纤维喉镜治疗。观察两组手术及嗓音恢复正常时间,两组术前、术后14d嗓音噪声学指标,术前、术后7d炎性因子,治疗后半年、1年复发情况。结果支撑喉镜组手术时间及嗓音恢复正常时间均小于纤维喉镜组(P<0.05)。术后14d,支撑喉镜组振幅微扰、基频微扰及标准化噪声能量等均低于纤维喉镜组(P<0.05)。支撑喉镜组IL-6、TNF-α及CRP水平均低于纤维喉镜组(P<0.05)。支撑喉镜组总有效率(93.22%)高于纤维喉镜组(76.27%)(P<0.05)。支撑喉镜组与纤维喉镜组半年复发率(3.39%vs 15.25%)、1年复发率(8.47%vs 23.73%)有差异有统计学意义(P<0.05)。结论支撑喉镜治疗VCP创伤小,免疫系统影响小,术后恢复快,复发率低,值得临床应用。

Objective To study the clinical effect of self-retaining laryngoscope in the treatment of vocal cord polyp(VCP).Methods One hundred and eighteen cases of VCP patients treated in our hospital from July 2015 to June 2017 were selected,follow the random number table all 118 patients with VCP were divided into fiberoptic laryngoscope group(n=59)and self-retaining laryngoscope group(n=59).Self-retaining laryngoscope group treated with self-retaining laryngoscope and fiberoptic laryngoscope group treated with fiberoptic laryngoscope in treatment.The surgery time and the voice recovery normal time of two group were observed,The preoperative and postoperative 14d voice noise indexes,preoperative and postoperative 7d inflammatory factors,relapse of six months and 1 years after treatment were compared between the two groups.Results The operation time and voice back to normal times of selfretaining laryngoscope group were less than fiberoptic laryngoscope group(P<0.05).14d after surgery,the amplitude perturbations,the frequency perturbation and standardized noise energy indicators of self-retaining laryngoscope group were lower than those of fiberoptic laryngoscope group(P<0.05).The IL-6,TNF-αand CRP levels of selfretaining laryngoscope group were lower than those of fiberoptic laryngoscope group(P<0.05).The recovery total effective rate of the self-retaining laryngoscope group(93.22%)was higher than that of the fiberoptic laryngoscope group(76.27%),P<0.05.The half a year recurrence rate after treatment(3.39%),the 1-year recurrence rate(8.47%)of self-retaining laryngoscope group were lower than the fiberoptic laryngoscope group(15.25%and 23.73%),P<0.05.Conclusion The treatment of VCP with self-retaining laryngoscope has little trauma,little immune system effect,quick postoperative recovery and low recurrence rate.It is worthy of clinical application.