CO_(2)激光术与传统剥脱术治疗声带白斑对嗓音的影响对比

Comparison of the Effects of CO_(2) Laser and Traditional Ablation for Vocal Cord Leukoplakia on Voice

目的:探究CO_(2)激光术与传统剥脱术治疗声带白斑对嗓音的影响。方法:回顾性分析2019年4月—2020年5月南阳市口腔医院耳鼻咽喉科诊治的43例声带白斑患者的病历资料作为研究对象。按手术方法的不同分为CO_(2)激光术组(采用CO_(2)激光切除术治疗,n=20例)和传统剥脱术组(采用传统剥脱术治疗,n=23)。比较两组疗效、主观嗓音障碍指数(VHI),进行嗓音分析。结果:CO_(2)激光术组治疗有效率为100%,传统剥脱术组治疗有效率为91.30%,CO_(2)激光术组治疗有效率与传统剥脱术相当;手术前两组主观嗓音障碍指数差异无统计学意义(t=0.055,P>0.05),手术后2周、手术后1个月主观嗓音障碍指数显著升高,CO_(2)激光术组主观嗓音障碍指数高于传统剥脱术组差异有统计学意义(t=3.361,3.121,P<0.05);两组患者手术后2周、手术后1个月嗓音的基频及最常发声时间较手术前升高,最低音强、振幅微扰、基频微扰较手术前降低,均有显著差异,手术后2周、手术后1个月CO_(2)激光术组基频、最常发声时间高于传统剥脱术组,最低音强、振幅微扰、基频微扰低于传统剥脱术组。两组术后均未出现严重并发症。结论:CO_(2)激光术组治疗声带白斑效果显著,能够对患者嗓音起到积极改善效果,具有一定临床价值,可进行广泛推广。

Objective:To explore the effects of CO_(2)laser surgery and traditional ablation to treat vocal cord leukoplakia on the voice.Methods:The medical records of 43 patients with vocal cord leukoplakia diagnosed and treated in the hospital from April 2019 to May 2020 were selected for retrospective analysis.According to different surgical methods,they were divided into CO_(2)laser surgery group(treated with CO_(2)laser resection,n=20)and traditional ablative surgery group(treated with traditional ablative surgery,n=23).The curative effect and subjective voice disorder index(VHI)of the two groups were compared,and voice analysis was performed.Results:The effective rate of treatment in the CO_(2)laser group was 100%,the effective rate in the traditional ablation group was 91.30%,and the effective rate in the CO_(2)laser group was equivalent to that of traditional ablation.There was no statistically significant difference in the subjective voice disorder index between the two groups before surgery(t=0.055,P>0.05).The subjective voice disorder index increased significantly 2 weeks after the operation and 1 month after the operation.The subjective voice disorder index in the CO_(2)laser surgery group was higher than that in the traditional ablation group.Two weeks after surgery and one month after surgery,the fundamental frequency and the most frequent vocalization time of the two groups of patients were higher than those before surgery,and the lowest sound intensity,amplitude perturbation,and fundamental frequency perturbation were lower than those before surgery.There were statistically significant differences,with statistically significant difference(t=3.361,3.121,P<0.05).Two weeks after surgery and one month after surgery,the fundamental frequency and the most frequent vocalization time of the CO_(2)laser group were higher than those of the traditional ablation group,and the lowest sound intensity,amplitude perturbation,and fundamental frequency perturbation were lower than those of the traditional ablation group.No serious complications occurred in the two groups.Conclusion:The CO_(2)laser surgery group is more effective in treating vocal cord leukoplakia,can positively improve the patients’voice,has certain clinical value,and can be widely promoted.