低温等离子消融术治疗早期声门型喉癌的疗效分析

发布时间：2018-01-09 20:02

本文关键词：低温等离子消融术治疗早期声门型喉癌的疗效分析　出处：《中华全科医学》2016年04期 　论文类型：期刊论文

【摘要】：目的分析低温等离子消融手术治疗早期声门型喉癌的近期疗效与安全性。方法选取2007年3月—2012年2月诊治的早期声门型喉癌患者93例,行低温等离子切除术43例,行喉部分切开术50例,统计2组患者的术后复发、并发症及短期生存率等情况。结果低温等离子切除患者中有2例复发,分别为T1b、T2,喉部分切除患者中共有5例患者复发,分别为Tis期1例、T1a期3例、T2期1例,2组间复发情况发生率差异不具有统计学意义(χ~2=0.950,P=0.329);行低温等离子切除患者仅有1例出现吞咽及呼吸障碍;而喉部分切除患者中切口感染5例、咽漏3例、吞咽及呼吸障碍4例,差异具有统计学意义(χ~2=9.032,P=0.003);研究随访3年,对所有患者进行生存状况统计显示,低温等离子组中5例(11.63%)患者病情进展死亡,T1b期2例(4.65%)、T2期3例(6.98%);喉部分切除术组死亡7例(18.00%),其中T1a期2例(4.00%)、T1b期2例(4.00%)、T2期3例(6.00%)。2组间生存率差异不具有统计学意义(χ~2=1.758,0.035,0.734,P0.05)。结论低温等离子消融术在治疗早期声门型喉癌中,组织损伤较轻,且并发症少,能够保证患者术后的生活质量,是早期声门型喉癌较理想的治疗选择,值得临床推广。
[Abstract]:Objective to analyze the short-term efficacy and safety of hypothermic plasma ablation in the treatment of early glottic laryngeal carcinoma. Methods 93 patients with early glottic laryngeal carcinoma from March 2007 to February 2012 were selected. 43 cases of hypothermic plasma resection and 50 cases of partial laryngotomy were performed. There were 5 cases of recurrence in partial laryngectomy, 1 case in stage Tis, 3 cases in stage T 1a and 1 case in stage T 2. There was no significant difference in the incidence of recurrence between the two groups (蠂 2: 0. 950). Only one patient with hypothermic plasma resection had dysphagia and respiratory disorders. There were 5 cases of incision infection, 3 cases of pharynx leakage, 4 cases of dysphagia and respiratory disturbance in partial laryngectomy. The study was followed up for 3 years. The survival status of all the patients was statistically analyzed. In the hypothermia plasma group, 5 cases (11.63%) died of stage T 1b stage 2 / 4.65% (P < 0.05). In T2 stage, 3 cases were inferior to 6.98; In the partial laryngectomy group, 7 cases died and 18.00% of them died, of which 2 cases were in stage T1a and 2 cases were in stage T1b. There was no significant difference in the survival rate among the 3 cases in T2 stage (蠂 ~ 2 = 1.758 ~ 0.035 卤0.734). Conclusion low temperature plasma ablation in the treatment of early glottic laryngeal carcinoma has less tissue damage and less complications, which can ensure the quality of life of the patients after operation. It is an ideal choice for early glottic laryngocarcinoma and is worthy of clinical promotion.
【作者单位】：深圳市宝安区松岗人民医院耳鼻喉科;广东省人民医院耳鼻喉科;
【基金】：广东省医学科研基金立项课题(A2014039)
【分类号】：R739.65
【正文快照】： 喉癌为头颈部第二大上皮性恶性肿瘤,在耳鼻喉科领域中仅次于鼻咽癌和鼻窦癌,居第三位。数据统计显示,喉癌发病率呈逐年上升趋势,占耳鼻咽喉恶性肿瘤的7.9%~35.0%,占全身恶性肿瘤的5.7%~7.6%,而在头颈肿瘤中,喉癌发生率约为14%,男性多见[1]。早期声门型喉癌治疗原则主要是彻底

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