低温等离子射频消融术联合A型肉毒素注射治疗难治性喉接触性肉芽肿的疗效分析

Analysis of low temperature plasma ablation combined with type A botulinum toxin injection in treatment of refractory laryngeal contact granuloma

目的研究低温等离子射频消融术联合A型肉毒素注射结合药物综合治疗难治性喉接触性肉芽肿的疗效。方法22例患者均为复发难治性声带突肉芽肿,采取低温等离子射频消融术联合局部肉毒素注射治疗方法,术后声带休息、抗胃食管反流等联合方法治疗,随访时间为1年,时间选取术后1周、术后1、3、6、12个月,均复查电子喉镜。结果22例患者经联合治疗后临床症状明显缓解,其中包括咽喉疼痛,咽喉部异物感、声嘶、咳嗽、咳痰等。术后随访6~12个月,术后3个月时,除1例患者病变复发,因患者拒绝再次手术,病变仍然存在,其余患者肉芽肿基本消失,电子喉镜下见双声带运动良好对称,随访6~12个月内未见复发。所有患者在治疗及随访期内全身及局部均未出现明显并发症。结论低温等离子射频消融术联合肉毒素注射综合治疗难治性喉接触性肉芽肿能够缩短治疗时间,明显提高治愈率,减少复发,疗效明显,值得临床进一步推广。

Objective To investigate the efficacy of low-temperature plasma radiofrequency ablation combined with type A botulinum toxin injection combined with drugs in the treatment of refractory laryngeal contact granuloma.Methods Totally 22 patients with recurrent refractory vocal cord granuloma were treated by plasma radiofrequency ablation combined with type A botulinum toxin injection,rest of vocal cord after operation and anti-gastroesophageal reflux drugs.Results The patients were followed up for 6~12 months after the operation.Except for 1 patient who had recurrence of the lesion refused the reoperation,the granuloma of the other patients basically disappeared.The bilateral vocal cord movement was well symmetrical through the electronic laryngoscope check,and no recurrence was observed 6~12 months after operation.No significant systemic or local complications occurred in all patients during the treatment and follow-up period.Conclusion low-temperature plasma radiofrequency ablation combined with type A botulinum toxin injection in the treatment of refractory laryngeal contact granuloma can shorten the treatment time,significantly improve the cure rate,reduce the recurrence.