摘要
目的研究CO_(2)激光声带部分切除术对声带白斑患者术后嗓音相关参数及远期疗效的影响。方法选取2021年1月至2022年10月声带白斑患者48例,按照随机数字表法随机分为对照组和研究组,每组患者24例。对照组患者采用传统剥脱术治疗;研究组患者采用CO_(2)激光术,激光治疗光斑直径1 mm,治疗功率1~3 W。术后1周至2年,采用显微喉镜复查,记录两组患者的临床治疗效果,评价患者远期疗效,观察并记录两组患者随访期间复发和并发症发生情况。分别于术前、术后1个月,记录两组患者基频微扰、振幅微扰和标准化声门噪声能量(normalized noise energy,NME)改变以评估患者嗓音功能。治疗前、治疗后2周、治疗后1个月,采用主观嗓音障碍指数(voice handicap index,VHI)对两组患者嗓音障碍情况进行评估。结果治疗后1个月,研究组临床总有效率优于对照组(P<0.05)。术后2年,研究组治愈率(95.8%)明显高于对照组(75.0%),差异具有统计学意义(P<0.05);研究组复发率(4.17%)低于对照组复发率(25.0%),研究组并发症发生率(4.2%)低于对照组(25.0%),差异具有统计学意义(P<0.05)。治疗前,两组患者基频微扰、振幅微扰和NME组间水平比较,差异无统计学意义(P>0.05);术后1个月,研究组基频微扰、振幅微扰水平降低,NME水平升高(P<0.05)。治疗前,两组患者VHI评分比较差异无统计学意义(P>0.05);术后2周和术后1个月,两组患者VHI评分水平均增加,且研究组明显高于对照组(P<0.05)。结论CO_(2)激光声带部分切除术可以明显改善声带白斑患者术后嗓音功能,远期疗效良好。
Objective To study the influence of CO_(2) laser-based partial vocal cord resection on postoperative voice related parameters and long-term curative effect on patients with vocal cord leukoplakia.Methods Totally 48 patients with vocal cord leukoplakia treated between Jan.2021 and Oct.2022 were selected and randomly divided into a control group(n=24)and a research group(n=24).The patients in the control group were given traditional peeling,and those in the research group were treated with CO_(2) laser.One month after the operation,the clinical therapeutic effects of the two groups were evaluated.Before the operation and one month afer the operation,the fundamental frequency perturbation,amplitude perturbation and normalized noise energy(NME)were recorded respectively to evaluate the voice function in the wo groups.Before the treatment and 2 weeks and 1 month after the treatment,the subjective voice handicap index(VHI)was used to evaluate the voice handicap of the patients in the two groups respectively.The patients were followed up for 2 years,and the long-term curative effects were evaluated.The complications found in the two groups were observed and recorded.Results The clinical effect was better in the research group than in the control group(P<0.05).Before the treatment,the levels of fundamental frequency perturbation,amplitude perturbation and NME in the control group were similar to those in the research group(P>0.05).One month after the operation,the levels of fundamental frequency perturbation and amplitude perturbation were lower in the research group,and the NME level higher in the research group(P<0.05).Before the treatment,the VHI score in the control group was the same as that in the research group(P>0.05).Two weeks and one month after the operation,the VHI score in both groups increased,but the growth was greater in the research group(P<0.05).Two years after the operation,the cure rate of the research group was 95.8%,higher than that(75.0%)of the control group(P<0.05).The recurrence rate of the study group was 4.17%,lower than the recurrence rate of the control group was 25.0%(P<0.05).Two years after the operation,the total incidence of complications in the research group was 4.17%,lower than that(25.0%)of the control group(P<0.05).Conclusions CO_(2) laser-based partial vocal cord resection will dramatically improve the postoperative voice function of patients with vocal cord leukoplakia and bring in good long-term effect.
作者
钱燕妮
王涛
QIAN Yanni;WANG Tao(Department of Otolaryngology,Daxing District People's Hospital,Beijing 102600,China)
出处
《中国激光医学杂志》
2025年第4期213-217,共5页
Chinese Journal of Laser Medicine & Surgery
关键词
声带白斑
激光
嗓音
疗效
Vocal cord leukoplakia
Laser
Voice
Curative ffeet
作者简介
钱燕妮(1985~),女,浙江人,主治医师,主要从事耳鼻咽喉科疾病研究。
