低温等离子射频消融术与传统外科切除术治疗早期喉癌的比较研究

Comparative Study of Low Temperature Plasma Radiofrequency Ablation and Traditional Surgical Resection for Early Laryngeal Carcinoma

目的探讨低温等离子射频消融术对早期喉癌患者复发及并发症的影响。方法回顾性选取2014年8月至2019年8月解放军总医院早期喉癌患者80例,依据1∶1对照原则分为离子组(n=40)和切开组(n=40),离子组给予低温等离子射频消融术,切开组给予喉部切开术,比较两组围术期、嗓音功能[最长发音时间(maximum pronunciation time,MPT)、声压级(sound pressure level,SPL)、基频(fundamental frequency,F0)、F0微扰(F0 perturbation,Jitter)]、并发症及复发情况。结果离子组术中出血量、黏膜恢复评分和手术、住院时间低于切开组,差异有统计学意义(P<0.05);离子组MPT、SPL高于切开组,离子组F0、Jitter低于切开组,差异有统计学意义(P<0.05);离子组并发症率低于切开组,差异有统计学意义(P<0.05);离子组和切开组1年复发率、无进展生存率、总生存率基本相同(P>0.05)。结论低温等离子射频消融术治疗早期喉癌具有操作简单、创伤小、并发症少、恢复快等优点,且不会增加复发及死亡风险,值得临床推广。

Objective To discuss the effect of low temperature plasma radiofrequency ablation on the recurrence and complication of patients with early laryngeal cancer.Methods A retrospective study of 80 patients with early laryngeal cancer in Chinese PLA General Hospital from August 2014 to August 2019 were selected,and they were divided into the ion group(n=40)and incision group(n=40)according to the 1∶1 control principle.The ion group was given low-temperature plasma radiofrequency ablation,and the incision group was given laryngectomy,the perioperative conditions,voice function[maximum pronunciation time(MPT),sound pressure level(SPL),fundamental frequency(F0),F0 perturbation(Jitter)],complications and recurrence were compared between the two groups.Results The intraoperative blood loss,mucosal recovery score,operation and hospitalization time in the ion group were lower than those in the incision group,the difference was statistically significant(P<0.05).The MPT and SPL in the ion group were higher than those in the incision group,the F0 and Jitter in the ion group were lower than those in the incision group,the difference was statistically significant(P<0.05).The complication rate in the ion group was lower than that in the incision group,the difference was statistically significant(P<0.05).The one-year recurrence rate,progression-free survival rate and overall survival rate in the ion group and incision group was basically the same(P>0.05).Conclusions The low temperature plasma radiofrequency ablation for the treatment of early laryngeal cancer had the advantages of simple operation,small trauma,fewer complications and rapid recovery,and it did not increase the risk of recurrence and death,it was worthy for further clinical promotion.