早期声门型喉癌钬激光与CO_(2)激光手术对比研究

Comparative study of holmium and CO_(2) laser surgeries for early glottic carcinoma

目的比较钬激光与CO_(2)激光手术治疗早期声门型喉癌临床疗效。方法回顾性分析激光手术治疗早期声门型喉癌91例的患者临床资料(T_(is),T_(1)N_(0)M_(0))。依据治疗方式分为钬激光手术组56例,CO_(2)激光手术组35例。对两组患者手术时间、出血量、并发症、住院时间、创面恢复时间和生存率等进行分析。结果钬激光组与CO_(2)激光组在术后疼痛评分(P=0.55)、住院时间(P=0.99)、并发症发生率(P=0.43),复发率(P=0.59)及喉保存率(P=0.64)等方面比较差异无统计学意义。两组患者在手术时间(P<0.01)、术中出血量(P=0.02)、创面愈合时间(P<0.01)等方面比较差异具有统计学意义。两组患者3年生存率比较差异无统计学意义(P=0.69)。结论经口支撑喉镜下钬激光和CO_(2)激光治疗早期声门型喉癌效果相当,前者手术时间更短。熟悉两种激光的应用,可避免开放手术,微创治疗肿瘤。

Objective To compare the clinical efficacies of holmium and CO_(2)lasers in the treatment of early glottic carcinoma.Methods The clinical data of 91 patients with early glottic laryngeal carcinoma treated by laser surgery were retrospectively analyzed(T_(is),T_(1)N_(0)M_(0)).Based on the treatment methods,the patients were divided into the holmium(56 cases)and CO_(2)(35 cases)laser surgery groups.The duration of surgery,blood loss,complications,hospital stay,wound recovery time,and survival rate were analyzed in the two groups.Results There were no statistically significant differences between the postoperative pain scores(P=0.55),hospital stay durations(P=0.99),complications rates(P=0.43),recurrence rates(P=0.59),and laryngeal preservation rates of the Holmium and CO_(2)laser groups(P=0.64).The blood loss(P=0.02)and the durations of surgery(P<0.01)and wound healing of the two groups(P<0.01)were statistically significant.There was no significant difference between the 3-year survival rates of the two groups(P=0.69).Conclusion Holmium and CO_(2)laser cordectomies have the same effect in the treatment of early glottic carcinoma,and the duration of the former is shorter.With familiarity with the application of the two types of laser,patients can avoid open surgery and undergo minimally invasive treatment of tumors.