探讨广基型声带息肉接受不同手术方式治疗的效果和对嗓音功能的影响

杨波

【摘要】 目的 探讨广基型声带息肉接受不同手术方式治疗的效果和对嗓音功能的影响。方法 80例广基型声带息肉患者， 随机分为对照组和观察组， 各40例。对照组采用纤维喉镜下YAG激光手術治疗， 观察组采用显微支撑喉镜手术治疗， 比较两组患者的手术效果、嗓音功能恢复情况、并发症发生情况。结果 观察组治疗总有效率为95.00%， 显著高于对照组的77.50%， 差异有统计学意义（P<0.05）。观察组基频微扰、振幅微扰、噪声能量、谐噪比等嗓音功能指标分别为（0.23±0.13）%、（1.26±0.45）%、（11.53±2.45）dB、（29.3±2.4）dB， 优于对照组的（0.44±0.16）%、（2.27±0.53）%、（7.52±3.08）dB、（20.6±2.7）dB，

差异有统计学意义（P<0.05）。观察组术后喉头水肿、声带粘连、舌头损伤、复发等并发症发生率为5.00%， 明显低于对照组的22.50%， 差异有统计学意义（P<0.05）。结论 采用显微支撑喉镜手术治疗广基型声带息肉效果更好， 有利于嗓音功能的早期恢复， 降低术后并发症发生率， 具有积极的临床意义。

【关键词】 广基型声带息肉；显微支撑喉镜；纤维喉镜下YAG激光；嗓音功能

DOI：10.14163/j.cnki.11-5547/r.2016.32.018

【Abstract】 Objective To investigate curative effects by different surgical measures for sessile polyp of vocal cord and their influence on voice function. Methods A total of 80 patients with sessile polyp of vocal cord were randomly divided into control group and observation group， with 40 cases in each group. The control group received fibro laryngoscopic YAG laser for surgery， and the observation group received micro self-retaining laryngoscope for surgery. Comparison was made on surgical effects， voice function recovery and complications between the two groups. Results The observation group had total effective rate as 95.00%， which was obviously higher than 77.50% in the control group， and the difference had statistical significance （P<0.05）. The observation group had voice function indexes of infinitesimal disturbance in fundamental frequency， infinitesimal disturbance in amplitude， noise energy and harmonics to noise ratio respectively as （0.23±0.13）%， （1.26±0.45）%， （11.53±2.45） dB and （29.3±2.4） dB， which were all better than （0.44±0.16）%， （2.27±0.53）%， （7.52±3.08） dB and （20.6±2.7） dB in the control group， and the difference had statistical significance （P<0.05）. The observation group had obviously lower incidence of postoperative laryngeal edema， vocal cord adhesion， tongue damage， and recurrence in complications as 5.00% than 22.50% in the control group， and the difference had statistical significance （P<0.05）. Conclusion Implement of micro self-retaining laryngoscope in surgical treatment of sessile polyp of vocal cord shows excellent effect. This method is beneficial for early voice function recovery and it can reduce incidence of postoperative complications. It contains positive clinical significance.

【Key words】 Sessile polyp of vocal cord； Micro self-retaining laryngoscope； Fibro laryngoscopic YAG laser； Voice function

广基型声带息肉是一种特殊的声带息肉类型， 发生于声带固有层浅层， 属于良性病变， 临床表现为声音嘶哑， 易发声疲劳， 保守治疗效果不佳， 最佳的治疗方式是手术切除[1]。临床常用的手术方法较多， 但传统纤维喉镜手术易造成声带损伤， 并容易遗留术后发声功能异常。随着喉部显微外科技术的发展， 在显微镜辅助下支撑喉镜切除术应用越来越广泛[2]。本研究对比显微支撑喉镜手术与纤维喉镜下YAG激光手术， 观察手术效果及对嗓音功能的影响， 现具体汇报如下。

1 资料与方法

1. 1 一般资料 选取2015年10月～2016年9月在本院耳鼻喉科接受治疗的80例广基型声带息肉患者， 随机分为观察组和对照组， 各40例。……