电视硬管喉镜下低温等离子消融术对侵及前联合早期喉癌的疗效观察

Therapeutic Effect of Low-temperature Plasma Ablation under TV Rigid Tube Laryngoscope on Invasion and Anterior Combination Early Laryngeal Cancer

目的:探究电视硬管喉镜辅助下低温等离子消融术治疗侵及前联合的早期喉癌的疗效。方法:选取本院2017年1月-2019年11月收治的侵及前联合的早期喉癌患者54例,根据手术方法不同分为等离子组(n=31)与对照组(n=23)。等离子组接受电视硬管喉镜下低温等离子消融术治疗,对照组接受喉垂直部分切除术治疗。比较两组手术相关指标、术后第2天疼痛程度及并发症发生情况。观察两组术后黏膜恢复及复发情况。结果:等离子组手术与住院时间均短于对照组,且等离子组术中出血量少于对照组,术后第2天疼痛程度低于对照组(P<0.05)。等离子组术后1周创面水肿基本消退,2周伪膜大部分形成。而对照组术后1周创面黏膜仍水肿,2周左右伪膜才逐渐形成。等离子组并发症发生率低于对照组(P<0.05)。对照组术后随访6个月~3年,出现复发3例,复发率为13.04%;等离子组术后随访3个月~2年,出现复发3例,复发率为9.68%,两组均为局部复发,无淋巴结及远处转移。结论:在侵及前联合的早期喉癌治疗中,电视硬管喉镜下低温等离子消融术具有创伤少、恢复时间短、并发症少的优点,效果显著,值得推广。

Objective:To explore the efficacy of low-temperature plasma ablation under TV rigid tube laryngoscope in the treatment of invasion and anterior combination early laryngeal cancer.Method:A total of 54 patients with invasion and anterior combination early laryngeal cancer admitted to our hospital from January2017 to November 2019 were selected.They were divided into plasma group(n=31)and control group(n=23)according to different surgical methods.The plasma group was treated with low-temperature plasma ablation under TV rigid tube laryngoscope,and the control group was treated with vertical partial laryngectomy.The surgical indicators,pain degree on the second day after surgery and complications were compared between the two groups.Postoperative mucosa recovery and recurrence in the two groups were observed.Result:The surgery and hospital stay time in the plasma group were lower than those in the control group,the intraoperative blood loss in the plasma group was shorter than that of the control group,and the degree of pain on the second day after the surgery in the plasma group was lower than that in the control group(P<0.05).In the plasma group,the edema of the wound surface basically subsided 1 week after the surgery,and after 2 weeks,most of the pseudomembrane was formed.However,in the control group,the wound mucosa was still edematous 1 week after the surgery,and the pseudo-membrane was gradually formed about 2 weeks later.The complication rate of the plasma group was lower than that of control group(P<0.05).The control group were followed up for 6 months to 3 years after the surgery,and there were 3 cases of recurrence,the recurrence rate was 13.04%.The plasma group was followed up for 3 months to 2 years after the surgery,and there were 3 cases of recurrence,the recurrence rate was 9.68%.Both groups had local recurrence without lymph node or distant metastasis.Conclusion:In the treatment of invasion and anterior combination early laryngeal cancer,low-temperature plasma ablation under TV rigid tube laryngoscope has the advantages of less trauma,short recovery time,and fewer complications.The effect is significant,which is worth promoting.