摘要
目的观察早期声门型喉癌患者行支持喉镜下CO_2激光术前后的嗓音功能及血清相关细胞因子水平的变化。方法选取2013年4月至2016年2月河北北方学院附属第二医院耳鼻咽喉科收治的早期声门型喉癌患者101例,按照随机数字表法将所有患者分为对照组(n=50)和观察组(n=51)。对照组行喉裂开喉部分切除术治疗,观察组行支持喉镜下CO_2激光术治疗。检测并比较两组患者手术前后的急性期时相蛋白、嗓音功能指标及血清相关细胞因子水平的变化。结果术后观察组患者血清C反应蛋白(CRP)、α1-酸性糖蛋白(α1-AG)及铜蓝蛋白(CER)均低于对照组,且差异均有统计学意义(P<0.05);术后2周至2个月,两组患者的基频(F0)、基频微扰(Jitter)先升高后降低,而声压级(SPL)、最长发声时间(MPT)及声音障碍指数(DSI)先降低后升高(P<0.05或P<0.01),且术后两组间各嗓音功能指标比较差异均有统计学意义(P<0.05或P<0.01);术后2个月时观察组患者除Jitter及MPT外,其余各指标与术前比较差异均无统计学意义(P>0.05);术后两组患者的血清白介素-2(IL-2)水平均升高,且观察组为(9.41±1.04)ng/m L,明显高于对照组的(7.26±1.31)ng/m L,差异有统计学意义(P<0.05);术后两组患者的血清白介素-6(IL-6)水平均降低,且观察组为(81.32±16.21)pg/m L,明显低于对照组的(108.96±19.03)pg/m L,差异有统计学意义(P<0.05)。结论支持喉镜下CO_2激光术治疗早期声门型喉癌具有术后应激小、可彻底切除肿瘤的优势,而且还可有效促进患者嗓音恢复,调节患者血清IL-2及IL-6等细胞因子水平,降低机体恶性程度。
Objective To observe the changes of voice function and serum related cytokine levels in the patients with early glottic cancer after microscopic support laryngoscope CO_2 laser. Methods A total of 101 cases early glottic cancer patients in Otorhinolaryngology Department of the Second Hospital Affiliated to Hebei North University from April 2013 to February 2016 were selected and divided into control group（n=50） and observation group（n=51） according to random number table. Throat open partial nephrectomy was carried out among the patients in the control group, microscopic support laryngoscope CO_2 laser in the observation group. The changes of levels of acute phase proteins, voice function indexes and serum related cytokine were detected and compared. Results The levels of C-reactive protein（CRP）, α1-acid glycoprotein（α1-AG） and copper blue protein（CER） in the observation group were lower than those in the control group（P〈0.05）. The fundamental frequency（F0）, Jitter in the two groups from 2 weeks to 2 months after operation showed a trend of increased first and reduced then, while the sound pressure level（SPL）, maximum phonation time（MPT） and dysphonia severity index（DSI） in the two groups showed a trend of reduced first and increased then（P〈0.05 or P〈0.01）, and the postoperative voice function indexes of 2 groups had significant difference（P〈0.05 or P〈0.01）. Expect the Jitter and MPT, the others indexes of observation group 2 months after operation had no significant difference（P〈0.05）. The interleukin-2（IL-2） levels after operation in the two groups increased significantly, which in the observation group was（9.41±1.04） ng/m L, higher than that（7.26±1.31） ng/m L in the control group significantly（P〈0.05）. The interleukin-6（IL-6） levels after operation in the two groups decreased significantly, which in the observation group was（81.32±16.21） ng/m L, lower than（108.96±19.03） ng/m L in the control group（P〈0.05）. Conclusion The postoperative stress of microscopic support laryngoscope CO_2 laser in the treatment of early glottic cancer is small, which not only has the advantage of radical resection, but also can promote the recover of voice function, adjust the cytokine levels of IL-2and IL-6, and reduce the body malignant degree.
出处
《海南医学》
CAS
2017年第11期1759-1761,共3页
Hainan Medical Journal
基金
河北省科学技厅项目(编号:20143297)
