直达喉镜下肿瘤切除手术联合干扰素治疗儿童喉乳头状瘤病的疗效

Direct Laryngoscope Tumor Resection Combined with Interferon in the Treatment of Laryngeal Papillomatosis in Children

目的:探讨直达喉镜下肿瘤切除手术联合干扰素治疗儿童喉乳头状瘤病的疗效。方法:回顾性分析2013年2月至2014年4月我院收治的喉乳头状瘤患儿38例,均行直达喉镜下肿瘤切除手术,根据术后治疗方法的不同,分为对照组(仅单纯手术治疗)和研究组(手术联合干扰素治疗),首次手术后检测凋亡抑制蛋白Livin阳性率。随访6个月,观察记录两组患儿的临床疗效。结果:研究组总有效率为90. 00%(18/20),高于对照组的38. 89%(7/18),差异有统计学意义(P<0. 01);研究组的复发率为25. 00%(5/20),低于对照组的94. 44%(17/18),差异有统计学意义(P<0. 01);首次手术后,研究组Livin蛋白的阳性率为30. 00%(6/20),对照组Livin蛋白阳性率为88. 89%(16/18),其中研究组Livin蛋白中、强阳性率为15. 00%(3/20),对照组Livin蛋白中、强阳性率为61. 11%(11/18),研究组Livin蛋白阳性率低于对照组(P<0. 01),尤其是中、强阳性率的差异较为显著(P<0. 01)。结论:儿童喉乳头状瘤病具有极高的复发率,直达喉镜下肿瘤切除手术联合干扰素治疗能有效降低复发率,临床效果较好。

Objective:To explore efficacy of direct laryngoscope tumor resection combined with interferon in the treatment of laryngeal papillomatosis in children. Methods:Retrospective analysis was conducted on 38 children with laryngeal papillomatosis admitted into our hospital from Feb. 2013 to Apr. 2014,all of whom underwent direct laryngoscope tumor resection. According to different postoperative treatment methods,all patients were divided into the control group( surgical treatment only) and the study group( surgical treatment combined with interferon therapy),and the positive rate of anti-apoptosis protein Livin was detected after the first surgery. After 6 months of follow-up,the clinical efficacy of two groups was recorded. Results:The total effective rate of the study group was 90. 00%( 18/20),higher than that of the control group 38. 89%( 7/18),the difference was statistically significant( P<0. 01). The recurrence rate of the study group was 25. 00%( 5/20),lower than that of the control group 94. 44%( 17/18),the difference was statistically significant( P<0. 01). After the first surgery,the positive rate of Livin protein in the study group was 30. 00%( 6/20),and in the control group was88. 89%( 16/18). The middle and strong positive rate of Livin protein in the study group was 15. 00%( 3/20),and in the control group was 61. 11%( 11/18),and that of the Livin protein in the study group was significantly lower than that in the control group( P<0. 05),especially the difference between the middle and strong positive rate was statistically significant( P<0. 05). Conclusion:The recurrence rate of children with laryngeal papillomatosis is relatively high,and direct laryngoscope tumor resection combined with interferon therapy can effectively reduce the recurrence rate,with better clinical effects.