支撑喉镜低温等离子治疗声带非典型增生疗效及对嗓音功能和血清相关细胞因子水平的影响

Curative Effect of Low-Temperature Plasma with Suspension Laryngoscope for Atypical Hyperplasia of Vocal Cords and Its Influence on Voice Functions and Serum Levels of Cytokines

目的:探讨支撑喉镜低温等离子治疗声带非典型增生的疗效,及对嗓音功能、血清白细胞介素-6(serum in-terleukin-6,IL-6)、肿瘤坏死因子-a(tumor necrosis factor-a,TNF-a)和C反应蛋白(C-reactive protein,CRP)水平的影响。方法:按照随机数字表法将2018年6月至2020年6月于自贡市第一人民医院耳鼻咽喉头颈外科接受诊疗的62例声带非典型增生患者分为两组,研究组30例、对照组32例。研究组采用支撑喉镜下低温等离子术治疗,对照组采用支撑喉镜下常规手术治疗,观察和比较两组患者治疗效果、术后嗓音功能恢复情况、血清IL-4、TNF-a和CRP水平变化情况。结果:研究组患者的手术时间和术中出血量均显著低于对照组,差异有统计学意义(P<0.05);研究组患者治疗总有效率、术后嗓音功能恢复优秀率均显著高于对照组,差异有统计学意义(P<0.05);治疗前,两组患者嗓音指标(Jitter、Shimmer、NNE)、IL-6、TNF-a和CRP水平差异无统计学意义(P>0.05);治疗后,研究组患者上述指标水平均显著低于对照组,差异有统计学意义(P<0.05);研究组患者术后并发症总发生率显著低于对照组,差异有统计学意义(P<0.05)。结论:支撑喉镜低温等离子治疗声带非典型增生疗效突出,具有嗓音功能恢复好、相对安全、可有效降低炎性反应等优势。

Objective:To explore the curative effect of low-temperature plasma with suspension laryngoscope in the treatment of atypical hyperplasia of vocal cords,and its influence on voice functions and levels of serum interleukin-6(IL-6),tumor necrosis factor-a(TNF-a)and C-reactive protein(CRP).Methods:With a random number table,62 patients with atypical hyperplasia of vocal cords diagnosed and treated in Zigong First People’s Hospital between June 2018 and June 2020 were assigned to the study group(30 cases)and the control group(32 cases).The study group was treated by low-temperature plasma with suspension laryngoscopy,while the control group was treated by conventional surgery with suspension laryngoscope.Therapeutic effects,postoperative voice function recovery,and changes in levels of serum IL-6,TNF-a and CRP were compared between the two groups.Results:Operation time and intraoperative blood loss in the study group were significantly shorter/less than those in the control group(P<0.05).The total response rate and the excellent rate of postoperative voice function recovery in study group were significantly higher than those in the control group(P<0.05).Before treatment,there were no significant differences between the two groups in voice indexes(Jitter,Shimmer,NNE)and levels of IL-6,TNF-a and CRP(P>0.05).After treatment,the above-mentioned indexes in the study group were significantly lower than those in the control group(P<0.05).The total incidence of postoperative complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion:L>ow-temperature plasma with suspension laryngoscope is effective and safe for atypical hyperplasia of vocal cords,with good voice function recovery and few inflammatory reactions.