摘要
目的:探究CO2激光声带切除术对于早期声门型喉癌患者嗓音的影响。方法:回顾性分析40例接受CO2激光治疗早期声门型喉癌患者的术前术后临床资料,记录患者术后复发率、存活率、并发症发生情况,对患者进行术前及术后的喉镜检查、嗓音障碍指数(VHI)简化中文版(VHI-13)量表评分,对影响喉癌患者术后稳定期声音质量进行探讨。结果:所有患者术后8~97个月进行嗓音评估,其中存活率为100%,无局部复发及明显术后并发症。喉癌组术后患者与健康对照组比较,基频(F0)、基频微扰(Jitter)、振幅微扰(Shimmer)、最长发声时间(MPT)差异均有统计学意义。累及前连合组较未累及前连合组Jitter、Shimmer指标差异均有统计学意义。VHI评分提示早期声门型喉癌患者术前大部分处于重度嗓音障碍,术后大部分处于中度嗓音障碍。喉癌组术后与健康对照组相比,健康对照组VHI评分总分、生理、心理、情感分数较低,喉癌组术前术后对比,术后VHI总分、生理评分都较低,差异均有统计学意义。结论:CO2激光手术治疗早期声门喉癌患者,术后存活率高,复发率低,并发症少;CO2激光手术导致明显声学参数改变;患者术后声音质量与是否累及前连合等因素相关;早期声门喉癌患者CO2激光术后VHI总分、生理评分优于术前。
Objective:The aim of this study is to investigate the effect of CO2 laser cordectomy on the voice of early glottic carcinoma.Method:A retrospective analysis of 40 patients who underwent CO2 laser treatment early glottis preoperative clinical data of postoperative laryngeal cancer patients,patients with postoperative recurrence rate,survival rate,and the postoperative complications of patients with preoperative and postoperative laryngoscopy,voice disorders index(voice handicap index,VHI)simplified Chinese version(VHI 13)rating scale,affecting the stability sound quality postoperatively in patients with laryngeal cancer were discussed.Result:All patients underwent voice reexamination 8-97 months after surgery,and the survival rate was 100%,no local recurrence and no obvious postoperative complications.Compared with the healthy control group,there were statistically significant differences in the four indicators F0(fundamental frequency),Jitter(fundamental frequency perturbation),Shimmer(amplitude perturbation)and MPT(maximum pronunciation time),suggesting that CO2 laser surgery resulted in significant changes in acoustic parameters.Jitter and Shimmer indexes in the pre involved combined group were statistically significant different from those in the non involved combined group,suggesting that the sound quality of the pre involved combined group was worse in the postoperative stability period.The VHI score indicated that most patients with early glottic cancer were in severe voice disorder before operation and most were in moderate voice disorder after operation.Compared with the healthy control group,the VHI score and total score of the healthy control group were lower in terms of physiology,psychology and emotion.Compared with the healthy control group,the VHI score and physiology of the early glottic laryngeal cancer patients were lower in the early glottic laryngeal cancer patients before and after surgery,and they were statistically significant.Conclusion:CO2 laser surgery for early glottic cancer,the overall survival rate of patients,low recurrence rate,fewer complications,CO2 laser surgery led to significant changes in acoustic parameters,postoperative sound quality and whether the involvement of pre-associated factors;The total score of VHI and physiological score of early glottic carcinoma patients after CO2 laser operation were better than those before operation.
作者
潘晓菲
王军
肖洋
PAN Xiaofei;WANG Jun;XIAO Yang(Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Beijing,100730,China)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2020年第2期162-165,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金
国家重点研发计划数字诊疗装备研发重点专项(No:2017YFC0112500)
北京市自然科学基金资助项目(No:7182036)
北京市医院管理局儿科学科协同发展中心儿科专项创新推广项目(No:XTCX201823).
关键词
喉肿瘤
CO2激光
嗓音分析
glottic laryngeal carcinoma
CO2laser
voice analysis
作者简介
通信作者:王军,E-mail:Wmzi2002@163.com
