颜玮宏

【摘要】 目的：分析早期喉癌患者應用CO2激光切除术与喉部分切除术治疗的差异。方法：选取2013年1月-2016年8月本院收治的早期喉癌患者60例为研究对象。按照随机数字表法将其分为甲组（n=30）、乙组（n=30）。甲组予以CO2激光切除术治疗，乙组予以喉部分切除术治疗。比较两组手术情况、近期疗效、并发症、术后1个月的嗓音学指标、术后1年的生活质量和复发情况。结果：甲组手术时间、术后2 d视觉模拟疼痛评分法（VAS）评分、喉黏膜水肿时间、住院时间均显著优于乙组，比较差异均有统计学意义（P<0.05）；甲组近期总有效率为96.7%，高于乙组的90.0%，但比较差异无统计学意义（P>0.05）；甲组并发症发生率为3.33%，低于乙组的20.00%，比较差异有统计学意义（ 字2=4.043 1，P=0.044 3）；术后1个月，甲组基频（F0）、基频微扰（Jitter）、声压级（SPL）、最长发音时间（MPT）、嗓音障碍指数（DSI）均显著优于乙组，比较差异均有统计学意义（P<0.05）；术后1年，两组各项生活质量评分及复发率比较，差异均无统计学意义（P>0.05）。结论：与喉部分切除术比较，早期喉癌患者应用CO2激光切除术治疗的术后恢复较快，并发症较少，但术后近期及远期效果无明显差异，是一种值得临床进一步应用与推广的治疗方法。

【关键词】 早期喉癌； CO2激光切除术； 喉部分切除术； 治疗效果

Efficacy of CO2 Laser Resection and Partial Laryngectomy in Treatment of Early Laryngeal Carcinoma/YAN Weihong.//Medical Innovation of China，2018，15（08）：128-131

【Abstract】 Objective：To analyze the difference between CO2 laser resection and partial laryngectomy in patients with early Laryngeal carcinoma.Method：A total of 60 patients with early Laryngeal carcinoma from January 2013 to August 2016 in our hospital were selected.According to the random number table method，they were divided into group A（n=30） and group B（n=30）.Group A was treated with CO2 laser resection and group B with partial laryngectomy.The operation，short-term effect，complications，the voice index after operation 1 month，the quality of life and recurrence after operation 1 year between two groups were compared.Result：The operation time，2 d visual analogue scale（VAS） score，postoperative laryngeal mucosal edema in time，hospitalization time in group A were significantly better than those of group B，the differences were statistically significant（P<0.05）.The short-term total efficiency of group A was 96.7%，which was higher than 90.0% of group B，but the difference was not statistically significant（P>0.05）.The complication rate of group A was 3.33%，which was lower than 20.00% of group B，the difference was statistically significant（ 字2=4.043 1，

P=0.044 3）.After operation 1 month，the fundamental frequency（F0），fundamental frequency perturbation（Jitter），sound pressure level（SPL），maximum phonation time（MPT），voice handicap index （DSI） in group A were significantly better than those of group B，the differences were statistically significant（P<0.05）.After operation 1 year，the scores of quality of life and the rate of recurrence in two groups were compared，the differences were not statistically significant（P>0.05）.Conclusion：Compared with partial laryngectomy，CO2 laser resection for early laryngeal carcinoma has faster postoperative recovery and fewer complications，but there is no obvious difference in the short-term and long-term effect，which is a kind of treatment method worthy of clinical application and promotion.

【Key words】 Early laryngeal carcinoma； CO2 laser resection； Partial laryngectomy； Treatment effect

First-authors address：Shenzhen Longgang District Otolaryngology Hospital，Shenzhen 518000，China

doi：10.3969/j.issn.1674-4985.2018.08.032

喉癌是头颈部中一种比较常见的恶性肿瘤。近些年来，随着废气、粉尘等致癌因素的不断增加，喉癌发病率越来越高[1]。针对早期喉癌而言，临床表现主要为声音嘶哑，如果治疗及时、有效，可显著改善患者预后，增加患者生存年限[2-3]。在以往早期喉癌治疗中，外科强调肿瘤彻底切除，而随着微创技术的不断发展，喉功能保留成为临床研究的重要课题，以此改善患者生活质量，增加患者生存年限[4]。……