不同手术方式对不同类型声带息肉摘除的临床疗效分析

发布时间：2018-03-07 05:07

本文选题：声带息肉　切入点：纤维鼻咽喉镜　出处：《浙江大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的比较表面麻醉纤维鼻咽喉镜与全身麻醉显微镜支撑喉镜下对不同类型声带息肉摘除的临床疗效。方法回顾性分析浙江大学附属邵逸夫医院2010年11月～2012年10月收治的164例声带息肉患者临床资料,66例患者采用表面麻醉纤维鼻咽喉镜下声带息肉摘除术(表面麻醉纤维鼻咽喉镜组,广基息肉27例、带蒂息肉39例),98例患者采用全身麻醉显微镜支撑喉镜下声带息肉摘除术(全身麻醉显微镜支撑喉镜组,广基息肉50例、带蒂息肉48例)。结果表面麻醉纤维鼻咽喉镜组与全身麻醉显微镜支撑喉镜组平均手术时间依次为(35.6±12.3)分钟、(46.5士17.6)分钟,两组比较,差异具有统计学意义(P0.05)；对于带蒂声带息肉病人,两组术后声学参数的变化,没有明显差异(P0.05)；对于广基声带息肉病人,两组术后声学参数的变化,有明显差异,全身麻醉显微镜支撑喉镜组效果优于表面麻醉纤维鼻咽喉镜组,差异具有统计学意义(P0.05)。全身麻醉显微镜支撑喉镜组不良并发症发生率为7.1%,稍高于表面麻醉纤维鼻咽喉镜组(4.5%),但无统计学差异(P0.05)。结论 1:对于不同类型声带息肉,从手术时间上看,我们认为表面麻醉纤维鼻咽喉镜下手术时间明显少于全身麻醉显微镜支撑喉镜下手术时间；2:对不同类型声带息肉采取不同术式治疗后嗓音参数分析,我们认为对于广基声带息肉,从手术疗效上选择术式,显微喉外科手术是最佳选择,对于带蒂声带息肉,显微镜支撑喉镜下手术和纤维鼻咽喉镜下手术,疗效相同。嗓音声学分析可以作为声带息肉病变手术方式选择、手术疗效评价、术后嗓音恢复情况判定的一个客观参考依据。
[Abstract]:Purpose. To compare the clinical effect of surface anesthesia fiber nose laryngoscope and general anesthesia microscope supporting laryngoscope on different types of vocal cord polyp removal. Method. The clinical data of 164 patients with vocal cord polyps treated by run run run Shaw Hospital affiliated to Zhejiang University from November 2010 to October 2012 were retrospectively analyzed. 66 patients with vocal cord polyps were treated with surface anesthesia fiber rhinolaryngoscope (superficial anesthesia fiber rhinolaryngoscope group). Twenty-seven cases of wide base polyps and 39 cases of pedicle polyps were treated with laryngoscope supported by general anesthesia microscope (50 cases with wide base polyps and 48 cases with pedicle polyps). Results. The average operative time of the fiberoptic laryngoscope group and the general anesthesia microscope support laryngoscope group was 35.6 卤12.3 minutes, 46.5 卤17.6 minutes respectively. The difference was statistically significant (P 0.05) for the patients with vocal cord polyps with pedicle. There was no significant difference in the changes of acoustic parameters between the two groups after operation (P 0.05). For the patients with wide base vocal cord polyps, there were significant differences in the postoperative acoustic parameters between the two groups. The effect of general anesthesia microscope supporting laryngoscope group was better than that of surface anesthesia fiber nasopharyngeal laryngoscope group. The incidence of adverse complications in general anesthesia microscope supported laryngoscope group was 7.1, which was slightly higher than that in surface anesthesia fiber nasopharyngeal laryngoscope group (4.5%), but there was no statistical difference (P 0.05). Conclusion. 1: for different types of vocal cord polyps, from the point of view of operation time, We think that the operating time under fiber nose laryngoscope under surface anesthesia is much shorter than that under laryngoscope supported by general anesthesia microscope: analysis of voice parameters after different types of vocal cord polyps treated with different methods. We think that microlaryngectomy is the best choice for polyps with broad base vocal cord, microlaryngectomy is the best choice for polyps with pedicle vocal cord, microlaryngoscope and fibro-nasolaryngoscope are the best choice for polyp of broad base vocal cord. The voice acoustic analysis can be used as an objective reference for the selection of surgical methods for vocal cord polyp lesions, the evaluation of surgical efficacy and the evaluation of postoperative voice recovery.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R767.91

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