多功能开口器下等离子射频手术治疗早期声门上型喉癌的疗效及对谐噪比水平的影响

Effect of Plasma Radiofrequency Surgery Under Multifunctional Mouth Gag in the Treatment of Early Supraglottic Carcinoma and on HNR

目的 探讨多功能开口器下等离子射频手术治疗早期声门上型喉癌的疗效及对谐噪比水平的影响。方法 选取62例早期声门上型喉癌患者作为研究对象,根据手术方法不同分为观察组和对照组,各31例。观察组患者采用多功能开口器下等离子射频手术治疗,对照组采用传统喉裂开声带切除术,对比2组患者手术情况、谐噪比水平的变化、吞咽功能、术后喉功能保存率及3个月、6个月局部控制率。结果 观察组患者手术持续时间、术中出血量、术后住院天数、疼痛评分(visual analogue scale,VAS)明显少于对照组,差异具有统计学意义(P<0.05)。手术1周后,观察组患者谐噪比水平高于对照组,差异具有统计学意义(P<0.05)。观察组吞咽功能有效率96.77%,高于对照组的67.74%,差异具有统计学意义(P<0.05)。观察组患者术后喉功能保存率为93.54%,高于对照组的70.96%,差异具有统计学意义(P<0.05)。结论 多功能开口器下等离子射频手术治疗早期声门上型喉癌能有效减少术中所需时间和出血量,缩短康复时间,减轻疼痛,保护发音功能、吞咽功能和喉功能,值得临床推广使用。

Objective To investigate the effect of plasma radiofrequency surgery under the multifunctional mouth gag in the treatment of early supraglottic carcinoma and its influence on harmonic to noise ratio(HNR).Methods A total of 62 patients with early supraglottic carcinoma were selected and divided into the observation group(n=31)and the control group(n=31)according to different surgical methods.The patients in the observation group were treated with plasma radiofrequency surgery under multifunctional mouth gag,while the patients in the control group were treated with traditional laryngeal dehiscence vocal cord resection.The surgical conditions,changes of HNR,swallowing function,postoperative preservation rate of laryngeal function and local control rate at 3 and 6 months were compared between the 2 groups.Results The operation time,blood loss,hospital stay and pain score(VAS)in the observation group were significantly less than that in the control group(P<0.05).One week after operation,the HNR level in the observation group was higher than that in the control group(P<0.05).The effective rate of swallowing function was higher in the observation group than in the control group(96.77%vs.67.74%,P<0.05).The postoperative laryngeal function preservation rate was higher in the observation group than in the control group;the laryngeal function preservation rate in the observation group than that in the control group(93.54%vs.70.96%,P<0.05).Conclusions Plasma radiofrequency surgery under multifunctional mouth gag can effectively reduce the intraoperative time and blood loss,shorten the rehabilitation time,reduce pain,protect pronunciation function,swallowing function and laryngeal function in patients with early supraglottic carcinoma.It is worthy of being widely popularized in the clinical application.