葡萄糖酸锌治疗声带手术后创伤性肉芽肿的临床疗效分析

发布时间：2018-03-29 12:38

  本文选题：声带手术　切入点：创伤性肉芽肿　出处：《大连医科大学》2017年硕士论文

【摘要】：目的:通过对声带手术后创伤性肉芽肿的患者给予口服葡萄糖酸锌治疗,从而探讨葡萄糖酸锌治疗创伤性肉芽肿的可行性与有效性。方法:回顾性分析2013年1月至2015年12月于大连市中心医院耳鼻咽喉科就诊的经病理活检确诊为声带手术后创伤性肉芽肿62例患者,对患者进行分组治疗,采用口服葡萄糖酸锌的40例患者(同时依据肉芽肿分度大小划分为A组22例与B组18例)作为药物组,治疗期限6个月,治疗后随访时间为1年;未经任何治疗的12例患者作为空白对照组,随访时间为1年;同时将10例愿意接受手术治疗的患者作为手术组,采用经内镜支撑喉镜下手术治疗,术后给予雾化吸入1周及声带休息2周,随访1年。所有患者咽喉反流阴性,病变都发生于声带手术术区,且均为初次确诊,确诊前都未行任何干预治疗。结果:药物组40例患者中,治愈34例,有效4例,无效2例,治愈率为85%,空白对照组12例患者中,治愈2例,有效1例,无效9例,治愈率为16.67%;手术组10例患者,4例治愈,有效3例,无效3例,治愈率40%;药物组与空白对照组的治愈率差异有统计学意义,药物组与手术组的治愈率差异有统计学意义。其中在药物组40例患者中,A组22例,治愈18例,有效3例,无效1例,治愈率为81.82%,B组18例,治愈16例,有效1例,无效1例,治愈率为88.89%,两组治愈率的差异无统计学意义。在随访期间,药物组患者中无1例复发,手术组中6例复发,药物组与手术组的复发率差异有统计学意义。结论:口服葡萄糖酸锌对声带手术后创伤性肉芽肿的治疗有效,其治愈率的高低与肉芽肿的大小无关;与手术治疗相比,对于声带手术后创伤性肉芽肿的治疗,口服葡萄糖酸锌是一种安全、经济、有效、复发率低,更易被患者所接受的疗法,值得在临床上广泛应用。
[Abstract]:Objective: to treat patients with traumatic granuloma after vocal cord surgery by oral administration of zinc gluconate. To explore the feasibility and effectiveness of zinc gluconate in the treatment of traumatic granuloma methods: from January 2013 to December 2015 in Department of Otolaryngology and Otorhinolaryngology, Dalian City Center Hospital, the diagnosis of vocal cord hand by pathological biopsy was retrospectively analyzed. Postoperative traumatic granuloma in 62 patients, 40 patients with zinc gluconate (22 patients in group A and 18 patients in group B) were divided into two groups according to granulomatous grading. The duration of treatment was 6 months and the follow-up time was 1 year. Twelve patients without any treatment were followed up for one year as a blank control group, while 10 patients who were willing to undergo surgery were treated with endoscopic laryngoscope. One week of atomization inhalation and 2 weeks of rest of vocal cord were given after operation. All the patients were followed up for 1 year. All the patients had negative throat reflux and the lesion occurred in the area of vocal cord surgery, and all of them were diagnosed for the first time. Results: in the drug group, 34 cases were cured, 4 cases effective, 2 cases ineffective, and the cure rate was 85%. In the blank control group, 2 cases were cured, 1 case was effective, 9 cases were ineffective. The cure rate was 16.67. In the operation group, 4 patients were cured, 3 patients were effective, 3 patients were ineffective, and the cure rate was 40.The difference of cure rate between the drug group and the blank control group was statistically significant. There was significant difference in the cure rate between the drug group and the operation group, in which 22 cases were cured, 18 cases were cured, 3 cases were effective, 1 case was ineffective, the cure rate was 81.82% in group B, 16 cases were cured, 1 case was effective, and 1 case was ineffective, among them, the cure rate was 81.82%, 16 cases were cured, 1 case was effective, and 1 case was ineffective. The cure rate was 88.89. There was no significant difference in the cure rate between the two groups. During the follow-up period, there was no recurrence in the drug group and 6 cases in the operation group. Conclusion: oral zinc gluconate is effective in the treatment of traumatic granuloma after vocal cord surgery, and the cure rate is not related to the size of granuloma. For the treatment of traumatic granuloma after vocal cord surgery, oral zinc gluconate is a safe, economical, effective, low recurrence rate, more easily accepted by patients, it is worth to be widely used in clinical.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R767.91
，

本文编号：1681178