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局部麻醉与全身麻醉下行注射喉成形术患者声音结果及并发症发生率的比较研究:一位阿德莱德嗓音专家的经验

A comparative study of voice outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia: an Adelaide voice specialist's experience.

作者信息

Chandran D, Woods C, Ullah S, Ooi E, Athanasiadis T

机构信息

Otorhinolaryngology,Head and Neck Surgery,Department of Surgery,Flinders University and Flinders Medical Centre,Adelaide,Australia.

Flinders Centre for Epidemiology and Biostatistics,School of Medicine,Flinders University,Adelaide,Australia.

出版信息

J Laryngol Otol. 2017 Jan;131(S1):S41-S46. doi: 10.1017/S0022215116009221.

Abstract

OBJECTIVE

To compare clinical outcomes and complication rates in patients undergoing injection laryngoplasty performed under local versus general anaesthesia.

METHODS

A retrospective review was conducted of patients who underwent injection laryngoplasty performed by a single laryngologist in a tertiary Australian laryngology centre, between February 2013 and December 2014. Patient demographics, anaesthetic modality and complications were recorded. Voice Handicap Index 10 and the Grade, Breathiness, Roughness, Asthenia, Strain scale were evaluated.

RESULTS

Thirty-four laryngoplasties were performed under general anaesthesia and 41 under local anaesthesia, with mean patient ages of 59.5 and 68.8 years, respectively. Voice Handicap Index 10 scores were significantly improved post-injection (p 0.05). All aspects of the Grade, Breathiness, Roughness, Asthenia, Strain scale showed significant improvement post-injection, except asthenia. There were seven (9.3 per cent) minor complications (five in the general anaesthesia group, two in the local anaesthesia group), all managed conservatively.

CONCLUSION

Injection laryngoplasties performed under general anaesthesia and local anaesthesia offer similar voice outcomes, with comparable complication rates. Hence, development of a management algorithm for injection laryngoplasties performed under local anaesthesia is recommended.

摘要

目的

比较在局部麻醉与全身麻醉下接受注射式喉成形术患者的临床疗效和并发症发生率。

方法

对2013年2月至2014年12月间在澳大利亚一家三级喉科学中心由一名喉科医生实施注射式喉成形术的患者进行回顾性研究。记录患者人口统计学资料、麻醉方式及并发症情况。评估嗓音障碍指数10(Voice Handicap Index 10)以及等级、呼吸音、粗糙音、无力音、紧张度量表。

结果

34例喉成形术在全身麻醉下进行,41例在局部麻醉下进行,患者平均年龄分别为59.5岁和68.8岁。注射后嗓音障碍指数10评分显著改善(p<0.05)。等级、呼吸音、粗糙音、无力音、紧张度量表的所有方面在注射后均有显著改善,但无力音除外。共有7例(9.3%)轻微并发症(全身麻醉组5例,局部麻醉组2例),均经保守处理。

结论

全身麻醉和局部麻醉下实施的注射式喉成形术嗓音疗效相似,并发症发生率相当。因此,建议制定局部麻醉下注射式喉成形术的处理方案。

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