内镜激光手术与喉裂开手术对喉癌患者呼吸、吞咽功能的影响

Effect of laser endoscopic surgery and laryngectomy on respiratory as well as swallowing functions in patients with laryngeal carcinoma

目的探讨内镜激光手术与喉裂开手术对喉癌患者呼吸、吞咽功能的影响。方法将80例早期声门型喉癌患者随机分为A组和B组,每组40例。A组采用支撑喉镜下CO 2激光术治疗,B组采用喉裂开部分切除术治疗。比较2组恢复情况、X线吞咽造影检查(VFSS)结果、改良误侵误吸计分量表(MPAS)评分、吞咽功能评估量表(GUSS)评分。结果A组手术时间、住院时间均短于B组,差异有统计学意义(P<0.05);术后12个月,A组黏膜恢复光滑例数多于B组,差异有统计学意义(P<0.05);术后14 d,A组MPAS评分低于B组,差异有统计学意义(P<0.05);术后30 d,A组GUSS评分高于B组,差异有统计学意义(P<0.05);A组并发症发生总例数为2例,少于B组的23例,差异有统计学意义(P<0.05)。结论CO 2激光术治疗早期声门型喉癌患者效果更佳,可有效改善患者呼吸、吞咽功能,减轻患者疼痛,减少并发症的发生,术后康复效果较好。

Objective To investigate the effect of laser endoscopic surgery and laryngectomy on respir atory as well as swallowing functions in patients with laryngeal carcinoma.Methods Eighty patients with early laryngeal carcinoma were randomly divided into group A and group B,with 40 cases in each group.Group A was treated with CO 2 laser surgery under supporting laryngoscope,and group B was treated with laryngectomy.The recovery,X-ray Videofluoroscopic Swallowing Study(VFSS)results,Modified Penetration-aspiration Scale(MPAS)score and Gugging Swallowing Screen(GUSS)score were compared between the two groups.Results The operation time and hospitalization time in the group A were significantly shorter than those in the group B(P<0.05);at 12 months after operation,the number of mucosa smooth in the group A was significantly higher than that in the group B(P<0.05);at 14 postoperative days,the MPAS score of the group A was significantly lower than that of the group B(P<0.05);at 30 postoperative days,the GUSS score of the group A was significantly higher than that of the group B(P<0.05).The total number of cases with complications in the group A were significantly lower than those in the group B(2 cases versus 23 cases,P<0.05).Conclusion CO 2 laser surgery is more effective in the treatment of patients with early laryngeal carcinoma,which can effectively improve the breathing and swallowing functions of patients,relieve pain of patients,reduce the incidence of complications,and achieve good postoperative rehabilitation effect.