摘要
目的观察CO2激光手术治疗复杂型声带息肉的疗效以及其对患者嗓音功能的影响。方法选取重庆市开州区人民医院2017年4月—2018年4月收治的复杂型声带息肉患者96例,随机分为对照组48例、观察组48例。对照组采用支撑喉镜下切除术治疗,观察组采用支撑喉镜下CO2激光手术治疗。比较两组喉镜检查结果(声门闭合程度、黏膜波波动幅度)、嗓音声学分析结果(基频微扰、振幅微扰、噪声能量、和谐噪比)、临床疗效(临床总有效率)、急性时相蛋白﹝C反应蛋白(CRP)、α1-酸性糖蛋白(α1-AG)、铜蓝蛋白(CER)﹞水平、康复情况(首次发声时间和声音完全恢复时间)。结果术后2周观察组声门闭合程度、黏膜波波动幅度小于对照组(P<0.05)。术后2周观察组基频微扰、振幅微扰小于对照组,噪声能量、和谐噪比大于对照组(P<0.05)。两组临床总有效率比较,差异无统计学意义(P<0.05)。观察组CRP、α1-AG、CER水平低于对照组(P<0.05)。观察组首次发声时间和声音完全恢复时间短于对照组(P<0.05)。结论对复杂型声带息肉患者采取CO2激光手术治疗,能有效恢复患者嗓音,且具有创伤较小、康复较快的优势。
Objective To investigate the effect of CO2 laser microsurgery on complicated vocal cord polyps and its influence on the voice function of patients.Methods From April 2017 to April 2018,96 patients with complex vocal polyps were selected from the People’s Hospital of Kaizhou District,and randomly divided into control group(48 cases)and observation group(48 cases).The patients in the control group were treated by resection under the support laryngoscope,while the observation group was treated with CO2 laser microsurgery under laryngoscope.Laryngoscopy results(glottal closure degree,mucosal wave amplitude),acoustic analysis of voice(alues of Jitter,alues of Shimmer,normalized noise energy,harmonic-to-noise ratio),clinical efficacy(total clinical efficacy),level of acute phase protein﹝C-reactive protein(CRP),α1-acid glycoprotein(α1-AG),ceruloplasmin(CER)﹞and rehabilitation(first vocal time and complete recovery time)were compared between the two groups.Results 2 weeks after the operation,the glottis closure degree and the amplitude of mucosal wave were lower in the observation group than in the control group(P<0.05).Observation group had lower values of Jitter and Shimmer as well as higher noise energy and harmonic-to-noise ratio than those of the control group(P<0.05).There was no significant difference in the total effective rate between the two groups(P>0.05).The levels of CRP,α1-AG and CER in the observation group were significantly lower than those in the control group(P<0.05).The first vocal time and complete recovery time of the observation group were shorter than those of the control group(P<0.05).Conclusion CO2 laser microsurgery for complicated vocal cord polyps can effectively restore the voice of patients,and has the advantages of less trauma and faster recovery.
作者
张瑜
汪祖益
ZHANG Yu;WANG Zuyi(The People's Hospital of Kaizhou District,CQ,Chongqing 405400,China)
出处
《中国全科医学》
CAS
北大核心
2019年第S02期64-66,159,共4页
Chinese General Practice
关键词
息肉
声带
复杂型声带息肉
激光疗法
CO2激光手术
治疗效果
嗓音功能
Polyps
Vocal cords
Complicated vocal cord polyps
Laser therapy
CO2 laser microsurgery
Treatment effectiveness
Vocal function
