中国耳鼻咽喉颅底外科杂志2017，Vol.23Issue(5)：461-465,5.DOI:10.11798/j.issn.1007-1520.201705015
支撑喉镜下声带白斑的手术治疗及预后分析
Surgical treatment under laryngoscope and prognosis of vocal cords leukoplakia
摘要
Abstract
Objective To analyze clinical factors affecting the prognosis of the vocal cord leukoplakia and compare the curative effect of CO2 laser and laryngeal microsurgery resection for this disease.Methods Clinical data of 60 patients suffering from vocal cord leukoplakia surgically treated in our hospital from Jan 2010 to Dec 2012 were analyzed retrospectively.The relationships between the prognosis of vocal cord leukoplakia and patients' gender,age,smoking,drinking,gastroesophageal reflux,operation method were analyzed.All the 60 patients were randomly divided into conventional group and laser group,30 cases in each group.The patients in the conventional group received laryngeal microsurgery under suspension laryngoscope while those of the laser group received focus resection with CO2 laser.Electronic laryngoscopy,stroboscopic laryngoscopy,GRBAS,VHI subjective scoring and objective voice analysis were performed to all patients before operation,1 week,1 month and 3 months after operation.Results Of all the 60 patients,the number of cases with history of long-term smoking,drinking and gastroesophageal reflux were 51 (85.00％),49(81.67％),and 35(58.33％) respectively.Multi-factor analysis revealed that the influences of patient's gender,age,smoking,drinking,gastroesophageal reflux on recurrence and malignant change of vocal cord leukoplakia were statistically insignificance (all P ＞ 0.05).Postoperative evaluations showed that the recovery of vocal cord wound in the laser group was slightly better than that of the conventional group at 1 week after operation.The result differences of electronic laryngoscopy,stroboscopic laryngoscopy,subjective and objective voice analyses between the two groups at 1 month to 3 months after operation were all statistically insignificance (all P ＞ 0.05).Postoperative long-term follow-up (1 year to 4 years) showed that the recurrence rate of the laser group (6.67％,2/30) was obviously lower than that of the conventional group (20％,6/30).Conclusion Smoking,drinking and gastroesophageal reflux are associated with the incidence of vocal cords leukoplakia,but not with its recurrence and malignant transformation.As for the therapeutic effect,laryngeal microsurgery is slightly better than CO2 laser in short-term,while the latter is superior to laryngeal microsurgery in long-term.关键词
声带白斑/CO2激光/预后Key words
Vocal cord leukoplakia/CO2 laser/Prognosis分类
医药卫生引用本文复制引用
毛承刚,万俐佳,周小淳..支撑喉镜下声带白斑的手术治疗及预后分析[J].中国耳鼻咽喉颅底外科杂志,2017,23(5):461-465,5.基金项目
荆州市科技局基金资助项目(2015028). （2015028）
