48例双侧广基型声带息肉患者不同术式疗效的主客观评估

Subjective and objective evaluation of the efficacy of different surgical procedures in 48 patients with bilateral sessile polyps of vocal cords

目的:探讨CO_(2)激光和CO_(2)激光联合显微缝合术治疗双侧广基型声带息肉的疗效。方法:将48例双侧广基型声带息肉患者随机分为CO2激光组和CO2激光+显微缝合组,结合主观评分及客观嗓音分析评估术后两组患者的手术效果以及疗效差异。结果:两组患者术后1个月和3个月基频微扰(Jitter)、振幅微扰(Shimmer)、嗓音障碍严重程度指数(DSI)及最长发声时间(MPT)、G分级、嗓音障碍指数(VHI-10)量表与术前比较差异均有统计学意义(P<0.05)。术后1个月和3个月两组患者之间Jitter、Shimmer、DSI和MPT的差异亦有统计学意义(P<0.05),但G分级、VHI-10比较差异无统计学意义(P>0.05)。CO2激光组和CO2激光+显微缝合组患者术后声带粘连发生率分别为8.3%和0,差异无统计学意义(P>0.05)。结论:CO_(2)激光联合显微缝合技术能够有效改善双侧广基型声带息肉患者嗓音质量,与单纯使用CO_(2)激光相比疗效更佳。

Objective:The aim of this study is to evaluate the efficacy of CO_(2)laser and CO_(2)laser combined with microsuture in the treatment of bilateral sessile polyps of vocal cords.Methods:Forty-eight patients with bilateral sessile polyps of vocal cords were randomly divided into CO_(2)laser group and CO2 laser combined with microsuture group.The surgical effect of each group and the difference between the two groups were evaluated by subjective score and objective voice analysis.Results:One month and three month after operation,Jitter,Shimmer,dysphonia severity index(DSI),the maximum phonation time(MPT),the parameters of G and voice handicap index(VHI-10)in the two groups were significantly different from pre-operation(P<0.05).There were also significant differences in Jitter,Shimmer,DSI and MPT between the two groups one month and three month after operation respectively(P<0.05).But no significant differences of the parameters of G and VHI-10 was noted between two groups(P>0.05).The incidence of postoperative vocal cord adhesion was 8.3%and 0 in two groups respectively,and there was no significant difference between the two groups(P>0.05).Conclusion:The CO_(2)laser combined with microsuturing technique can effectively improve the voice quality of patients with bilateral wide-based vocal cord polyps,and the effect is better than that of using CO_(2)laser alone.