支撑喉镜及新型声带息肉挤切钳切除对声带息肉患者嗓音声学指标的影响

Effect of Laryngoscopy and a New Type of Vocal Cord Polyp Forceps on Vocal Acoustic Indicators in Patients with Vocal Cord Polyps

目的分析支撑喉镜下新型声带息肉挤切钳切除术对声带息肉患者的疗效及嗓音声学指标恢复的影响。方法对许昌市人民医院2020年10月至2022年12月行声带息肉切除术患者60例临床资料进行分析,根据手术方式分为A组(32例)、B组(28例),A组接受支撑喉镜下新型声带息肉挤切钳切除术进行声带息肉切除,B组在直视支撑喉镜下行声带息肉切除术。观察两组患者手术疗效、术后并发症、术后各时点嗓音声学指标变化情况。结果A、B组患者术前、术后各时点嗓音声学指标经重复测量方差分析显示:处理效应与时间效应的交互作用有统计学意义(P<0.05)。术后2、4周时两组组内Jitter、Shimmer参数低于术前,术后4周低于术后2周;术后2、4周NNE、H/N指标高于术前;术后2、4周A组Jitter、Shimmer参数低于B组,NNE、H/N指标高于B组(P<0.05)。A组临床治疗总有效率高于B组,术后并发症发生率低于B组(P<0.05)。结论支撑喉镜下新型声带息肉挤切钳切除术对声带息肉患者的临床疗效较好,患者术后并发症少,嗓音声学指标恢复较快。

Objective To analyze the therapeutic effect of a new type of vocal cord polyp resection forceps under supportive laryngoscope on vocal cord polyp patients and the impact of voice acoustic index recovery.Methods A clinical analysis was conducted on 60 patients who underwent vocal cord polypectomy in People’s Hospital of Xuchang from October 2020 to December 2022.They were divided into group A(32 cases)and group B(28 cases)based on the surgical methods adopted.Group A underwent vocal cord polypectomy using a new type of vocal cord polypectomy forceps under a support laryngoscope,while group B underwent vocal cord polypectomy under a direct vision support laryngoscope.The surgical efficacy and postoperative complications,the changes in voice acoustic indicators at various time points after surgery of two groups of patients were observed.Results A,B group of patients with preoperative and each point postoperative voice acoustic index by the repeated measurement variance analysis showed that the interaction between treatment effect and the time effect was statistically significant(P<0.05).Jitter and Shimmer parameters in both groups were lower at 2 and 4 weeks after surgery than before surgery,and 4 weeks after surgery than 2 weeks after surgery.NNE and H/N indexes were higher at 2 and 4 weeks after surgery than those before surgery.Jitter and Shimmer parameters of group A were lower than those of group B 2 and 4 weeks after operation.The indexes of NNE and H/N were higher than those of group B(P<0.05).The total effective rate of group A was higher than that of group B,and the incidence of postoperative complications was lower in group B(P<0.05).Conclusion The clinical efficacy of a new type of vocal cord polyp resection forceps under supportive laryngoscope is good for patients with vocal cord polyps,with fewer postoperative complications and faster recovery of voice acoustic indicators.