二氧化碳激光与常规冷器械切除声带良性病变的手术效果比较

Comparison of surgical effects between carbon dioxide laser and conventional cold apparatus in the resection of benign lesions of vocal cord

摘要:

目的 比较二氧化碳（CO2）激光与常规冷器械切除声带良性病变的手术效果。方法 选取2018年12月-2020年12月于四川省会理市人民医院接受治疗的200例良性声带病变的患者，依据双盲法分为A组（100例）与B组（100例）。A组行行常规冷器械法治疗，B组CO2（2下标，下同）激光切除术治疗，术后采用视频频闪、声学分析和VHI（语音障碍指数）对各组进行评价。结果 两组结节、息肉、囊肿、黏膜白斑病对比无明显差异（P>0.05）。A组术后3个月的闪烁噪声、嗓音抖动、基频均小于A组术前, 术后3个月的MPT大于术前（P<0.05）。B组术后3个月的闪烁噪声、嗓音抖动、基频均小于B组术前, 术后3个月的MPT大于术前（P<0.05）。两组术前和术后3个月的闪烁噪声、嗓音抖动、基频、MPT对比无明显差异（P>0.05）。A组术后3个月的VHI的躯体、功能、情感、总计均小于A组术前（P<0.05）。B组术后3个月的VHI的躯体、功能、情感、总计均小于B组术前（P<0.05）。两组术前和术后3个月的VHI的躯体、功能、情感、总计对比无明显差异（P>0.05）。结论 两种手术技术在处理良性声带病变方面都有良好的疗效，但各有其优缺点。

Abstract:

Objective To compare the surgical effects of carbon dioxide laser and conventional cold instruments for resection of benign vocal cord lesions. Methods A total of 200 patients with benign vocal cord lesions treated in Huili People's Hospital of Sichuan Province from December 2018 to December 2020 were selected and divided into group A (100 cases) and group B (100 cases) according to double-blind method. Group A received conventional cold instrument treatment, group B received CO2 (2 subscript, same below) laser resection, postoperative visual scintigraphy, acoustic analysis and VHI (speech impairment index) were used to evaluate each group.Results There were no significant differences in nodule, polyp, cyst and mucosal leukoplakia between the two groups (P>0.05). The scintillation noise, voice shaking and fundamental frequency of group A were all lower than those of group A before operation 3 months after operation, and the MPT was higher than that before operation 3 months after operation (P<0.05). The scintillation noise, voice shaking and fundamental frequency of group B were lower than those of group B before operation 3 months after operation, and the MPT of group B was higher than that before operation 3 months after operation (P<0.05). There were no significant differences in scintillation noise, voice shaking, fundamental frequency and MPT between the two groups before and 3 months after operation (P>0.05). The body, function, emotion and total of VHI in group A 3 months after operation were lower than those in group A before operation (P<0.05). The body, function, emotion and total of VHI in group B 3 months after operation were lower than those in group B before operation (P<0.05). There were no significant differences in body, function, emotion and total VHI between the two groups before and 3 months after operation (P>0.05).Conclusion Both surgical techniques have good results in treating benign vocal cord lesions, but each has its advantages and disadvantages.