喉结缩小术在女性和易性症(男转女)群体中的应用

Application of chondrolaryngoplasty in female patients and transgenders(male-to-female)

目的探讨喉结缩小术在女性患者和易性症(男转女)者中应用效果及异同。方法回顾性分析2016年3月至2019年9月在北京大学第三医院行喉结缩小术的受术者资料,采用11点Likert量表对患者进行平均14个月随访,调查围手术期恢复情况、整体满意度、喉结整体外观满意度、喉结突出自我评分及心理社交评分。根据性别将受术者分为女性组和易性症组,运用SPSS 22.0进行数据处理和分析,术前、后采用配对样本t检验,组间样本使用独立样本t检验,P<0.05为差异具有统计学意义。结果共纳入23例受术者,女性组11例,易性症组12例,年龄(26.87±5.54)岁,范围18~37岁。术后平均随访14个月,手术整体满意度95.65%(22/23);喉结整体外观满意度为82.61%(19/23)。所有受术者自我喉结突出评分由术前(6.57±2.45)分改善至术后(2.22±2.09)分,社交功能限制评分从术前平均(6.30±3.02)分改善为术后(1.52±2.54)分,心理负担评分由术前平均(7.70±2.44)分降至术后(1.83±2.62)分,术前、后比较差异均有统计学意义(P<0.01)。同时易性症组喉结突出自我评分改善值和社交功能限制改善值均显著高于女性组(P<0.05)。结论喉结缩小术可以显著改善受术者喉结局部外观,易性症者通过喉结缩小术可以获得比女性更好的社交与心理改善程度。

Objective To investigate the similarities and differences of chondrolaryngoplasty between female and male-to-female transgender patients.Methods A retrospective analysis focused on the case with chondrolaryngoplasty in Peking University Third Hospital from March 2016 to September 2019.Patients were followed up an average 14mths with an eleven-point Likert scale.We assigned patients into a female(n=11)and transgender women(n=12)groups,using SPSS 22.0 tool to process and analyze data.The paired sample t test is conducted to compare pre-and postoperative differences,while independent sample t test is to compare between groups;a P-value less than 0.05 is considered to have statistical significance.Results A total of 23 patients were enrolled,including 11 female patients and 12 transgender patients,aged 18 to 37 years old(mean 26.87±5.54 years old).Satisfaction with surgery is 95.65%(22/23 patients),satisfaction with the appearance of laryngeal prominence is 82.61%(19/23 patients).After the operation,the Self-Estimate Laryngeal Prominence Score improves from 6.57±2.45 to 2.22±2.09,the Social Ability Restriction Score improves from 6.30±3.02 to 1.52±2.54,the Phycological Burden Score decrease from 7.70±2.44 to 1.83±2.62,all data have statistical significances(P<0.01).The improvement value of the previous two scores is greater than the transgender women group with statistical significances(P<0.05).Conclusions Chondrolaryngoplasty can remarkably improve the appearance of laryngeal prominence of patients.Transgenders women can obtain better social and phycological improvement than female patients after chondrolaryngoplasty.