173例声带麻痹患者的病因学特点

Etiological characteristics of vocal cord paralysis in 173 patients

目的分析声带麻痹(VCP)患者的病因学特点。方法回顾性分析2016年9月—2019年9月于安徽医科大学附属省立医院耳鼻咽喉头颈外科就诊的173例确诊为VCP的患者,统计其临床特征并分析致病原因。结果173例VCP患者中,92例(53.2%)左侧VCP,36例(20.8%)右侧VCP,45例(26.0%)双侧VCP。医源性损伤包括:牵拉伤、热灼伤、离断伤等,损伤部位在左侧、右侧或双侧的不同解剖位置。医源性损伤105例(60.7%)居首位;其次是喉外肿瘤和占位性病变31例(17.9%)。结论单侧VCP较双侧VCP常见,左侧较右侧更为常见。不同病因所致VCP嗓音学特点各不相同,即使同一病因所致VCP,因损伤的程度、性质及解剖位置不同,嗓音学特征差异也较大,可比性较低。医源性损伤仍是导致VCP的首要原因,其次是喉外肿瘤和占位性病变。抗病毒药物、激素联合营养神经药物的保守治疗或可作为病毒感染或特发性病因的首选治疗,但对治疗效果不应抱有过高期待。

Objective To analyze the etiological characteristics of vocal cord paralysis(VCP).Methods A retrospective analysis on 173 patients diagnosed with VCP in our department from Sept 2016 to Sept 2019 was performed.Their clinical characteristics and the causes of VCP were analyzed.Results Of all the 173 patients,92(53.2%)had left-sided VCP,36(20.8%)had right-sided VCP,and 45(26.0%)had bilateral VCP.Iatrogenic injuries included traction injury,thermal burn,and amputation injury.The injury sites were in different anatomical positions on the left,right,or both sides.As for the causes,iatrogenic injuries in 105 cases(60.7%)topped the list,followed by extralaryngeal tumors and space-occupying lesions in 31 cases(17.9%).Conclusions Unilateral VCP is more common than bilateral VCP,and the left VCP is more common than the right side.The VCPs of different causes have different vocal characteristics.Even the VCPs of the same cause may have great characteristic differences and low comparability due to differences in the degree,nature and anatomical location of injury.Iatrogenic injury remains the primary cause of VCP,followed by extralaryngeal tumors and space-occupying lesions.The conservative treatment of antiviral drugs and hormones combined with neurotrophic drugs may be the preferred treatment for VCP of viral infections or idiopathic causes,but high therapeutic effect should not be expected too much.