摘要
目的评价显微镜下支撑喉镜下CO2激光治疗早期声门型喉癌的临床疗效、术后并发症、患者生存情况、复发相关因素以及术后嗓音功能恢复情况。方法 回顾性分析吉林大学第二医院耳鼻咽喉头颈外科2014年1月~2018年12月间收治的早期声门型喉癌患者40例,评价CO2激光手术的近期和远期临床疗效、术后并发症及复发相关因素、黏膜恢复情况以及嗓音功能恢复情况等。结果 对40例患者进行术后随访,随访时间6个月~5年,其中失访6例,随访者无死亡病例,术后半年出现远处转移1例,术后1年于对侧声带出现癌变1例,局部复发2例。术后创面完全愈合期为(3.2±0.3)个月。18例患者出现新生声带,与无声带新生组相比,嗓音质量具有显著差异。患者术后生存质量高,喉保留率达97.5%。术后并发症少,2例出现声带粘连,1例出现术后出血,2例出现舌体麻木,2例出现误咽及呛咳,余患者均未出现严重并发症。结论 CO2激光对于治疗早期声门型喉癌临床疗效显著,对患者病变范围准确评估后进行CO2激光下内镜下声带病变切除后喉功能保留率高、并发症少、复发率低、损伤小恢复快,术后患者生活质量及发音质量均明显提高,是早期声门型喉癌安全有效的治疗方法。
OBJECTIVE To evaluate the clinical effect, complications, survival rate, recurrence related factors and vocal function recovery after transorol CO2 laser microsurgery for early glottic cancer. METHODS From January 2014 to December 2018, the clinical data of 40 cases with early glottic cancer in the Second Hospital of Jilin University were retrospectively studied. All the patients were treated with CO2 laser laryngeal microsurgery. The short-term follow-up, long-term effect, complications and recurrence related factors, the situation of wound recovery and voice function recovery were evaluated. RESULTS All the patients were followed-up from 6 months to 5 years after operation. Six patients failed to be followed up, 2 received a second operation due to recurrence and survived well. Distant metastasis was found in one patient. Contralateral vocal cord canceration was found in one patient. The wound healing period was(3.2±0.3) months. New vocal cords appeared in 18 patients, and the quality of voice was significantly better compared with the group without new vocal cords. The total reservation rate of the laryngeal function was 97.5%. All operations were successful without serious complications. Of the all 40 cases, vocal cord adhesion occurred in 2 cases, hemorrhage occurred in 1 case, tongue numbness occurred in 2 cases, and aspiration and choking cough occurred in 2 cases. CONCLUSION CO2 laser surgery is an effective and safe surgical method for early glottic cancer with high reservation rate of the laryngeal function, fewer complications, low recurrence rate, less bleeding and faster recovery. And postoperative quality of life and sound quality of the patients were significantly improved.
作者
王迪
刘岩
文连姬
张慧慧
边晓敏
谷婷婷
于丹
WANG Di;LIU Yan;WEN Lianji;ZHANG Huihui;BIAN Xiaomin;GU Tingting;YU Dan(Department of Otolaryngology Head and Neck Surgery,the Second Hospital of Jilin University,Changchun,Jilin,130041,China)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2019年第9期472-475,共4页
Chinese Archives of Otolaryngology-Head and Neck Surgery
关键词
喉肿瘤
激光手术
治疗结果
手术后并发症
Laryngeal Neoplasms
Laser Therapy
Treatment Outcome
Postoperative Complications
