低温等离子射频消融技术在喉部良性及癌前病变的应用体会

目的探讨低温等离子射频消融技术治疗喉部良性病变及癌前病变的手术疗效。方法将喉部良性及癌前病变患者共58例分为观察组和对照组。观察组共30例采用低温等离子射频消融术治疗,对照组共28例采用喉钳进行病灶切除术。比较观察组与对照组的手术时间、出血量、术后喉部症状和咽部不适(VAS评分)以及术后并发症、复发等情况。结果观察组术中出血量、手术时间、伤口愈合时间、术后喉部症状和咽部不适感评分均明显低于对照组,差异有统计学意义(P<0.05);观察组出现创面迟发性出血1例,对照组出现并发症3例,分别为急性喉水肿、继发性出血及创面感染;术后随访6个月〜2年,观察组复发1例,对照组复发3例。两组并发症及复发率比较,差异无统计学意义(P>0.05)。结论低温等离子射频消融技术可微创治疗喉部良性及癌前病变,手术时间短,术中出血量少,术后喉部症状及咽部不适感轻,术后恢复快,并发症少,值得基层医院推广使用。

Objective To investigate the effect of low temperature plasma radiofrequency ablation in the treatment of benign laryngeal lesions and precancerous lesions.Methods 58 cases of laryngeal benign and precancerous lesions were treated.There were 30 cases in the observation group,which were treated by low temperature plasma radiofrequency ablation;28 cases in the control group were treated with laryngeal forceps.The operation time,bleeding volume,postoperative laryngeal symptoms,pharyngeal discomfort(VAS score),postoperative complications and recurrence were compared between the observation group and the control group.Results The bleeding volume,operation time,wound healing time,laryngeal symptoms and pharyngeal discomfort scores in the observation group were significantly lower than those in the control group(P<0.05)In the observation group,1 case had delayed bleeding,and in the control group,3 cases had complications,including acute laryngeal edema,secondary bleeding and wound infection.The patients were followed up for 6 months to 2 years.In the observation group,1 case had recurrence;in the control group,3 cases had recurrence.There was no significant difference in complication and recurrence rate between the two groups(P>0.05).Conclusion Low temperature plasma radio&equency ablation can treat benign and precancerous lesions of the larynx minimally,with short operation time,less intraoperative bleeding,less postoperative pharyngeal discomfort and laryngeal symptoms,quick postoperative recovery,less complications.It is worth popularizing in primary hospitak.