低温等离子射频消融术治疗早期声门型喉癌患者的效果

Effects of low temperature plasma radiofrequency ablation in treatment of patients with early glottic laryngeal carcinoma

目的:观察低温等离子射频消融术治疗早期声门型喉癌(EGC)患者的效果。方法:回顾性分析2018年4月至2019年5月该院收治的87例EGC患者的临床资料,按治疗方法不同分为对照组42例和研究组45例。对照组予以垂直半喉切除术治疗,研究组予以低温等离子射频消融术治疗,比较两组手术相关指标(手术时间、术中出血量、住院时间)水平,术后1、3、5 d疼痛[视觉模拟评分法(VAS)]评分,术前及术后3个月嗓音功能(振幅微扰、基频微扰、谐噪比),并发症发生率,1年内肉芽增生发生率及喉癌远处转移率。结果:研究组手术时间和住院时间短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);术后1、3、5 d,研究组VAS评分均低于对照组,差异有统计学意义(P<0.05);术后3个月,两组振幅微扰、基频微扰均低于术前,且研究组低于对照组,两组谐噪比均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为6.67%(3/45),低于对照组的23.81%(10/42),差异有统计学意义(P<0.05);两组1年内肉芽增生发生率和喉癌远处转移率比较,差异均无统计学意义(P>0.05)。结论:低温等离子射频消融术治疗EGC患者可改善手术相关指标水平和嗓音功能,降低术后VAS评分和并发症发生率,效果优于垂直半喉切除术治疗。

Objective: To observe effects of low temperature plasma radiofrequency ablation in treatment of patients with early glottic laryngeal carcinoma(EGC). Methods: The clinical data of 87 EGC patients admitted to this hospital from April 2018 to May 2019 were retrospectively analyzed, and they were divided into control group(42 cases) and study group(45 cases) according to different treatment methods. The control group was treated with vertical hemilaryngectomy, while the study group was treated with low temperature plasma radiofrequency ablation.The levels of surgery-related indicators(operation time, intraoperative blood loss, hospitalization time), the postoperative pain scores [1, 3, and 5days postoperative visual analogue scale(VAS)], the voice function(amplitude perturbation, fundamental frequency perturbation, harmonic-to-noise ratio) before and 3 months after the surgery, the incidence of complications, and the incidence of proliferation of granuloma and the distant metastasis rate of laryngeal cancer within 1 year were compared between the two groups. Results: The operation time and the hospitalization time in the study group were shorter than those in the control group;the intraoperative blood loss was less than that in the control group;and the differences were statistically significant(P<0.05). 1, 3, and 5 days after the surgery, the VAS scores of the study group were lower than those of the control group, and the differences were statistically significant(P<0.05). 3 months after the surgery, the amplitude perturbation and the fundamental frequency perturbation of the two groups were lower than those before the surgery, and those of the study group were lower than those of the control group;the harmonic-tonoise ratios of the two groups were higher than those before the surgery, and that of the study group was higher than that of the control group;and the differences were statistically significant(P<0.05). The incidence of complications in the study group was 6.67%(3/45), which was lower than 23.81%(10/42) in the control group, and the difference was statistically significant(P<0.05). However, there were no significant differences in the incidence of proliferation of granuloma and the distant metastasis rate of laryngeal cancer between the two groups within 1 year(P>0.05). Conclusions: Low temperature plasma radiofrequency ablation in the treatment of the EGC patients can improve the level of surgery-related indicators and the voice function, and reduce the postoperative VAS score and the incidence of complications. Moreover, it is superior to vertical hemilaryngectomy.