显微支撑喉镜下CO2激光手术与联合干扰素治疗复发性小儿喉乳头状瘤的临床研究

发布时间：2018-04-15 05:27

本文选题：喉肿瘤/治疗 + 乳头状瘤/治疗　；参考：《山东大学》2011年硕士论文

【摘要】：目的：探讨白细胞干扰素联合显微支撑喉镜下CO2激光手术治疗复发性小儿喉乳头状瘤的临床疗效。方法：回顾性分析2004-2009年山东大学齐鲁医院耳鼻喉科收治的61例复发性小儿喉乳头状瘤的临床资料,所有喉乳头状瘤复发患者,均经术后病理检查证实,均行显微支撑喉镜下CO2激光手术治疗；按术后治疗方法不同分为单纯手术组和手术与干扰素联合治疗组,并进行随访。参照UICC制定的解剖分区以及Lusk RP采用的解剖划分法,以双侧声带,前联合,双侧喉室,双侧室带,会厌喉面,杓会厌皱襞,声门下分为各个解剖亚区。术后随访3个月,依照解剖划分法测量乳头状瘤的解剖和体积分类。比较术前、术后肿瘤范围大小。以了解单纯显微支撑喉镜下CO2激光及其联合干扰素治疗复发性小儿喉乳头状瘤的临床效果。结果：共收集到61例复发性小儿喉乳头状瘤的患者资料,其中30例行单纯显微支撑喉镜下CO2激光手手术治疗,31例行手术联合干扰素治疗(联合治疗组)。比较治疗前后乳头状瘤范围,单纯手术组治疗前、后对比,乳头状瘤复发范围均有明显减少,经统计分析,按照P0.05标准,差别有统计学意义。联合治疗组乳头状瘤复发范围有明显减少,经统计分析,按照P0.05标准,差别有统计学意义。联合治疗组与单纯手术组治疗后乳头状瘤范围相比较,联合治疗组较单纯手术组复发范围小；经统计学分析,按照P0.05标准,差别有统计学意义。结论：单纯显微支撑喉镜下CO2激光手术与其联合干扰素治疗复发性小儿喉乳头状瘤均能延缓肿瘤复发。联合治疗组较单纯手术组复发范围小,能够减少再次手术时喉腔内正常粘膜的损伤从而降低喉狭窄等并发症的发生率,有进一步研究应用的价值。
[Abstract]:Objective: to investigate the clinical effect of leukocyte interferon combined with microlaryngoscopic CO2 laser in the treatment of recurrent laryngeal papilloma in children.Methods:The clinical data of 61 patients with recurrent laryngeal papilloma in Qilu Hospital of Shandong University from 2004 to 2009 were retrospectively analyzed. All patients with recurrent laryngeal papilloma were confirmed by postoperative pathological examination.All patients were treated with CO2 laser under microlaryngoscope and were divided into simple operation group and interferon combined group according to the postoperative treatment methods and followed up.According to the anatomical partition made by UICC and the anatomic division of Lusk RP, the anatomic subzones of bilateral vocal cord, anterior joint, bilateral laryngeal ventricle, bilateral ventricular zone, epiglottic larynx, arytenic fold and subglottic subglottic were divided.After 3 months follow-up, the anatomy and volume classification of papilloma were measured.The range of tumor was compared before and after operation.Objective to investigate the clinical effect of CO2 laser and interferon in the treatment of recurrent laryngeal papilloma in children under microlaryngoscope.Results:A total of 61 cases of recurrent laryngeal papilloma in children were collected. Among them, 30 cases were treated by microlaryngoscopic CO2 laser hand surgery and 31 cases were treated with interferon combined with surgery (combined treatment group).Compared the scope of papilloma before and after treatment, simple operation group before and after treatment, papilloma recurrence range were significantly reduced, after statistical analysis, according to P0.05 standard, the difference was statistically significant.The range of recurrence of papilloma in combined treatment group was significantly reduced, according to the standard of P0.05, the difference was statistically significant.The range of posterior papilloma in the combined treatment group and the simple operation group was smaller than that in the simple operation group. After statistical analysis, the difference was statistically significant in accordance with the P05 standard.Conclusion: CO2 laser surgery combined with interferon can delay the recurrence of recurrent laryngeal papilloma in children.The combined treatment group has smaller recurrence range than the simple operation group, which can reduce the injury of normal mucosa in laryngeal cavity during reoperation and reduce the incidence of complications such as laryngeal stenosis, which has the value of further study and application.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R739.65

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