CO_(2)激光凝固术辅助治疗血管性声带炎患者的效果

Effects of CO_(2) laser coagulation in adjuvant treatment of patients with vascular chorditis

目的:探讨CO_(2)激光凝固术辅助治疗血管性声带炎患者的效果。方法:选取78例血管性声带炎患者为研究对象,采用随机数字表法分为对照组、观察组各39例。两组均给予常规康复训练,在此基础上,对照组给予雾化吸入布地奈德混悬液联合口服金嗓散结丸治疗,观察组在对照组基础上给予CO_(2)激光凝固术治疗。比较两组治疗前后声门闭合情况、声学指标[振幅微扰、谐噪比(HNR)、基频微扰]水平、嗓音障碍指数(VHI)及治疗后6个月内复发情况。结果:治疗后,两组声门闭合程度评分均低于治疗前,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。治疗后,观察组振幅微扰、基频微扰值均低于对照组,HNR值高于对照组;观察组生理、情感、功能及VHI总分均低于对照组,差异有统计学意义(P<0.05)。随访6个月,观察组复发率为5.13%(2/39),显著低于对照组的20.51%(8/39),差异有统计学意义(P<0.05)。结论:CO_(2)激光凝固术联合常规疗法治疗血管性声带炎患者效果显著,能改善患者嗓音质量,减轻发声障碍,降低复发率,且不影响声门闭合程度。

Objective: To explore effects of CO_(2) laser coagulation in adjuvant treatment of patients with vascular chorditis. Methods:78 patients with vascular chorditis were selected as the research objects and were divided into control group and observation group by using the random number table method, 39 cases in each group. Both groups were given routine rehabilitation training. On this basis, the control group was given aerosol inhalation Budesonide suspension combined with oral administration of Jinsang Sanjie pills, while the observation group was given CO_(2) laser coagulation on the basis of those of the control group. The glottal closure before and after the treatment, the acoustic index levels [amplitude perturbation, harmonic to noise ratio(HNR), fundamental frequency perturbation], the voice disturbance index(VHI) and the recurrence within 6 months after the treatment were compared between the two groups. Results: After the treatment, the scores of glottal closure degree in both groups were lower than those before the treatment, and the difference was statistically significant(P<0.05);however, there was no significant difference between the two groups(P>0.05). After the treatment, the amplitude perturbation and the fundamental frequency perturbation values of the observation group were lower than those of the control group;the HNR value was higher than that of the control group;the total scores of physiology,emotion, function and the VHI were lower than those of the control group;and the differences were statistically significant(P<0.05). After 6 months of follow-up, the recurrence rate in the observation group was 5.13%(2/39), which was significantly lower than the control group of 20.51%(8/39),and the difference was statistically significant(P<0.05). Conclusions: CO_(2) laser coagulation combined with conventional therapy has a significant effect in the treatment of the patients with vascular chorditis, which can improve the quality of the patients’ voice, reduce the dysphonia, reduce the recurrence rate, and does not affect the degree of glottal closure.