声门型喉癌等离子微创手术并一期V型喉硅胶膜置入的临床研究
发布时间：2018-12-14 06:34
【摘要】：目的:总结低温等离子微创手术并一期V型喉硅胶膜置入治疗T1、部分T2期声门型喉癌的术后临床恢复情况。方法:回顾我院2013年3月至2015年3月收治的符合入选条件的30例行低温等离子微创手术并一期V型喉硅胶膜置入与35例行传统喉裂开手术并一期V型喉硅胶膜置入治疗早期声门癌的患者术后情况并进行统计学分析。结果:65例病例根据所采取的手术术式分为低温等离子微创手术并一期V型喉硅胶膜置入组(研究组)和传统喉裂开手术并一期V型喉硅胶膜置入组(对照组),其中研究组30例,对照组35例。研究组30例中后无一例术后出现呼吸困难;对照组35例中有2例患者出现呼吸困难;两组呼吸程度的比较不存在统计学差异(P0.05)。研究组30例患者中术后无明显疼痛者19例,术后轻度疼痛者11例,无术后中、重度疼痛者;对照组35例患者中术后无明显疼痛者9例,术后轻度疼痛者20例,术后有中度疼痛者6例,无术后重度疼痛者。两组患者疼痛程度(NRS评分)比较存在统计学差异(P0.05)。研究组30例患者中术后检查随访发现黏膜不光滑者1例;对照组35例患者中术后检查随访发现黏膜不光滑者4例。两组患者术后黏膜愈合情况比较不存在统计学差异(P0.05)。根据误咽分级,研究组30例患者中术后0级误咽28例,1级误咽2例;对照组中35例患者中术后0级误咽30例,1级误咽5例。两组病例术后均未出现2级和3级误咽且两组病例在吞咽功能的比较上不存在统计学差异(P0.05)。根据GRBAS嗓音评估系统中的总嘶哑度对两组患者术后发音功能进行评估,研究组30例患者中术后总嘶哑度评估1级的有23例,2级的6例以及3级的1例;对照组35例患者中术后总嘶哑度评估1级19例,2级9例以及3级7例。两组病例在发音功能的比较上存在统计学差异(P0.05)。结论:本研究证明低温等离子微创手术并一期V型喉硅胶膜置入治疗早期声门型喉癌较传统喉裂开手术一期V型喉硅胶膜置入治疗早期声门型喉癌对患者术后减轻疼痛,发音功能恢复方面存在优势,而对术后呼吸功能、吞咽功能及粘膜愈合情况的影响方面两种术式效果相当。
[Abstract]:Objective: to summarize the clinical recovery of patients with T 1, T 2 stage glottic laryngeal carcinoma treated by low temperature plasma minimally invasive surgery and one stage V type laryngeal silicone film implantation. Methods: from March 2013 to March 2015, 30 cases of low temperature plasma minimally invasive surgery and one stage V type laryngeal silicone film implantation and 35 cases of traditional laryngotomy and one stage V type laryngeal silicone film placement were retrospectively reviewed in our hospital. The postoperative status of patients with early glottic carcinoma was analyzed statistically. Results: 65 cases were divided into low temperature plasma minimally invasive operation and one stage V type laryngeal silicone film implantation group (study group) and traditional laryngotomy with one stage V type larynx silicone film implantation group (control group). There were 30 cases in the study group and 35 cases in the control group. There was no postoperative dyspnea in 30 cases in the study group and 2 cases in the 35 cases in the control group. There was no significant difference in respiratory degree between the two groups (P0.05). In the study group, there were 19 cases of no obvious postoperative pain, 11 cases of mild postoperative pain, and no postoperative moderate or severe pain. In the control group, 9 cases had no obvious postoperative pain, 20 cases had mild pain, 6 cases had moderate pain, and no severe postoperative pain. The pain degree (NRS score) was significantly different between the two groups (P0.05). In the study group, 1 case was found to have mucosal unsmoothness after operation and 4 cases were found to have mucosal unsmoothness in 35 cases in the control group. There was no statistical difference between the two groups in mucosal healing after operation (P0.05). According to the grade of false pharynx, there were 28 cases in grade 0 and 2 cases in grade 1 in study group, and 30 cases in grade 0 and 5 cases in grade 1 in control group. There were no grade 2 or 3 grade false pharynx in the two groups after operation and there was no statistical difference in the swallowing function between the two groups (P0.05). According to the total hoarseness in the GRBAS voice evaluation system, the postoperative articulation function of the two groups was evaluated. In the study group, 23 patients were evaluated with the total hoarseness of postoperative grade 1, 6 with the second grade and 1 with the third grade in the study group. In the control group, the total hoarseness was evaluated in 19 cases of grade 1, 9 cases of grade 2 and 7 cases of grade 3 after operation. There was statistical difference in pronunciation function between the two groups (P0.05). Conclusion: this study demonstrated that the treatment of early glottic laryngeal carcinoma with low-temperature plasma minimally invasive surgery combined with one-stage V-type laryngeal silicone film implantation was more effective than that of traditional laryngotomy in the treatment of early glottic laryngeal carcinoma. There were advantages in the recovery of articulation function, but the effects on postoperative respiratory function, swallowing function and mucosal healing were similar.
【学位授予单位】：河南科技大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.65
本文编号：2378107
[Abstract]:Objective: to summarize the clinical recovery of patients with T 1, T 2 stage glottic laryngeal carcinoma treated by low temperature plasma minimally invasive surgery and one stage V type laryngeal silicone film implantation. Methods: from March 2013 to March 2015, 30 cases of low temperature plasma minimally invasive surgery and one stage V type laryngeal silicone film implantation and 35 cases of traditional laryngotomy and one stage V type laryngeal silicone film placement were retrospectively reviewed in our hospital. The postoperative status of patients with early glottic carcinoma was analyzed statistically. Results: 65 cases were divided into low temperature plasma minimally invasive operation and one stage V type laryngeal silicone film implantation group (study group) and traditional laryngotomy with one stage V type larynx silicone film implantation group (control group). There were 30 cases in the study group and 35 cases in the control group. There was no postoperative dyspnea in 30 cases in the study group and 2 cases in the 35 cases in the control group. There was no significant difference in respiratory degree between the two groups (P0.05). In the study group, there were 19 cases of no obvious postoperative pain, 11 cases of mild postoperative pain, and no postoperative moderate or severe pain. In the control group, 9 cases had no obvious postoperative pain, 20 cases had mild pain, 6 cases had moderate pain, and no severe postoperative pain. The pain degree (NRS score) was significantly different between the two groups (P0.05). In the study group, 1 case was found to have mucosal unsmoothness after operation and 4 cases were found to have mucosal unsmoothness in 35 cases in the control group. There was no statistical difference between the two groups in mucosal healing after operation (P0.05). According to the grade of false pharynx, there were 28 cases in grade 0 and 2 cases in grade 1 in study group, and 30 cases in grade 0 and 5 cases in grade 1 in control group. There were no grade 2 or 3 grade false pharynx in the two groups after operation and there was no statistical difference in the swallowing function between the two groups (P0.05). According to the total hoarseness in the GRBAS voice evaluation system, the postoperative articulation function of the two groups was evaluated. In the study group, 23 patients were evaluated with the total hoarseness of postoperative grade 1, 6 with the second grade and 1 with the third grade in the study group. In the control group, the total hoarseness was evaluated in 19 cases of grade 1, 9 cases of grade 2 and 7 cases of grade 3 after operation. There was statistical difference in pronunciation function between the two groups (P0.05). Conclusion: this study demonstrated that the treatment of early glottic laryngeal carcinoma with low-temperature plasma minimally invasive surgery combined with one-stage V-type laryngeal silicone film implantation was more effective than that of traditional laryngotomy in the treatment of early glottic laryngeal carcinoma. There were advantages in the recovery of articulation function, but the effects on postoperative respiratory function, swallowing function and mucosal healing were similar.
【学位授予单位】：河南科技大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.65
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