中国癌症杂志 ›› 2020, Vol. 30 ›› Issue (2): 142-147.doi: 10.19401/j.cnki.1007-3639.2020.02.009

• 论著 • 上一篇    下一篇

喉部分切除术和经口内镜CO 2 激光显微手术治疗前联合阳性早期声门癌患者的疗效比较

胡 磊 1 ,董红军 1 ,徐 浩 1 ,袁毅方 2 ,王耀华 1   

  1. 1. 张家港市中医医院,江苏 张家港 215600 ;
    2. 张家港市人民医院,江苏 张家港 215600
  • 出版日期:2020-02-29 发布日期:2020-03-09
  • 通信作者: 王耀华 E-mail: huhjkg@163.com
  • 基金资助:
    吴门医派马氏喉科学术思想的传承研究(SYSD2014179)。

Comparison of efficacy between partial laryngectomy and oral endoscopic CO 2 laser microsurgery in patients with early positive glottic carcinoma before treatment

HU Lei 1 , DONG Hongjun 1 , XU Hao 1 , YUAN Yifang 2 , WANG Yaohua 1   

  1. 1. Zhangjiagang Hospital of Traditional Chinese Medicine, Zhangjiagang 215600, Jiangsu Province, China; 2. Zhangjiagang People’s Hospital, Zhangjiagang 215600, Jiangsu Province, China
  • Published:2020-02-29 Online:2020-03-09
  • Contact: WANG Yaohua E-mail: huhjkg@163.com

摘要: 背景与目的:早期声门癌患者虽然发病率不高,但该病对患者语言功能、生活质量等均有明显影响。治疗早期声门癌的临床手术方法较多,不同疗法在不同文献报道中存在较大差异。比较喉部分切除术、经口内镜CO 2 激光显微手术分别治疗前联合阳性早期声门癌患者的疗效差异。方法:2015年11月—2018年5月,对张家港市中医医院128例前联合阳性早期声门癌患者进行研究,按住院单双日分为两组,根据治疗方式的不同分为试验组(经口内镜CO 2 激光显微手术)和对照组(喉部分切除术),每组64例。比较两组患者治疗前后吞咽功能和生活质量评分、患者治疗前后嗓音声学指标、临床资料、临床疗效的差异。结果:试验组患者基频微扰(Jitter)、振幅微扰(Shimmer)指标显著低于对照组患者(P<0.05),试验组患者标准规范化噪声能量(normalized noise energy,NNE)、谐噪比(harmonics to noise ratio,HNR)指标显著高于对照组患者(P<0.05);试验组患者标准吞咽功能评定量表(standardized swallowing assessment,SSA)评分显著低于对照组患者(P<0.05);试验组患者手术时间、术中出血量显著低于对照组患者(P<0.05);两组患者临床疗效比较,试验组治愈人数显著高于对照组患者(Z=6.671,P=0.036)。结论:经口内镜CO 2 激光显微手术相比传统的喉部分切除手术,治疗前联合阳性早期声门癌患者的疗效相对更佳,有助于患者嗓音功能、吞咽功能等的恢复。

关键词: 喉部分切除术, CO 2 激光, 声门癌, 疗效比较

Abstract: Background and purpose: Although incidence rate of early glottic cancer is not high, this disease has a significant impact on patients’ language function and quality of life. There are many surgical treatment methods for early glottic cancer, and various therapies have great differences in literature reports. We compared the curative effects of partial laryngectomy and endoscopic CO 2 laser microsurgery in patients with combined positive early glottic cancer before treatment. Methods: From Nov. 2015 to May 2018, 128 patients with pre-combined positive early glottic cancer were divided into two groups according to odd or even dates of hospitalization, and according to the different treatment methods, the patients were divided into the experimental group (transoral endoscopic CO 2 laser microsurgery) and the control group (partial laryngectomy). The scores of swallowing function and quality of life before and after treatment, acoustic indexes, clinical data and clinical efficacy before and after treatment were compared between the two groups. Results: After the treatment, Jitter and Shimmer indexes in the experimental group were significantly lower than those in the control group (P<0.05), and normalized noise energy (NNE) and harmonics to noise ratio (HNR) indexes in the experimental group were significantly higher than those in the control group (P<0.05). After treatment, standardized swallowing assessment (SSA) scores in the experimental group were significantly lower than those in the control group (P<0.05). The operative time and intraoperative blood loss of patients in the experimental group were significantly lower than those in the control group (P<0.05). Compared with the clinical efficacy between the two groups, the number of patients cured in the experimental group was significantly higher than that in the control group (P<0.05). Conclusion: Compared with traditional partial laryngectomy, transoral endoscopic CO 2 laser microsurgery has a better curative effect on patients with early positive glottic cancer before treatment, which is helpful for the recovery of voice function and swallowing function.

Key words: Laryngectomy, CO 2 laser, The glottis cancer, Comparative effectiveness