内镜下氩离子凝固术和支撑喉镜下切除术治疗声门暴露困难声带良性病变临床疗效比较

Clinical Comparison of Endoscopic Argon Plasma Coagulation and Supporting Laryngoscopic Resection for Vocal Cord Benign Lesions Patients with Difficult Glottis Exposure

目的探讨内镜下氩离子凝固术和支撑喉镜下切除术治疗声门暴露困难声带良性病变的临床疗效及安全性差异。方法选取我院2017年1月至2019年12月收治的声门暴露困难声带良性病变患者共45例,按照“真实世界”研究(real world study,RWS)设计理论,根据患者意愿非随机选择治疗措施,分为实验组(25例)和对照组(20例),分别行内镜下氩离子凝固术和支撑喉镜辅助切除术治疗。比较两组围手术期指标、临床疗效及术后并发症发生率。结果实验组手术时间、住院时间及住院费用均少于对照组,术后并发症发生率低于对照组,差异均有统计学意义(P<0.05)。术后3月疗效评价,实验组治愈16例,好转8例,无效1例,总有效率为96%;对照组治愈10例,好转8例,无效2例,总有效率为90%;两组总有效率比较,差异无统计学意义(P>0.05)。结论内镜下氩离子凝固术治疗声门暴露困难声带良性病变可获得与支撑喉镜下切除术相近的疗效,并能够缩短手术时间,加快术后康复进程,有助于降低术后并发症发生风险。

Objective To investigate the clinical effects and safety of endoscopic argon plasma coagulation and supporting laryngoscopic resection for vocal cord benign lesions patients with difficult glottis exposure.Methods A total of 45 vocal cord benign lesions patients with difficult glottis exposure admitted from January 2017 to December 2019 in our hospital were selected and divided into two groups according to real word study(RWS).The surgery of endoscopic argon plasma coagulation was performed in the experiment group(n=25),and supporting laryngoscopic resection in the control group(n=20).The peri-operative index,clinical effect and post-operative complication rate was compared between the two groups.Results The operation time,hospitalization time and hospitalization cost was less and the postoperative complication incidence was lower in the experimental group than those in the control group,and all the differences were significantly(P<0.05).The clinical result was revealed that 16 cases of cured,8 cases of improvement and 1 case of invalid in the experimental group with 96%of total effective rate,and 10 cases of cured,8 cases of improvement and 2 case of invalid in the control group with 90%of total effective rate.There was no significant difference in total effective rate between the two groups(P>0.05).Conclusion The surgery of argon plasma coagulation under endoscope can achieve the similar clinical effects with supporting laryngoscopic resection for vocal cord benign lesions patients with difficult glottis exposure,it can shorten the surgery time,accelerate the recovery process,and is helpful to reduce the postoperative complication risk.