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单侧后声门扩张术治疗双侧声带麻痹性呼吸困难的临床研究

[Clinical research of unilateral posterior glottic cleft dilatation in the treatment of bilateral vocal cord paralysis dyspnea].

作者信息

Hu Shousen, Zhao Chang

机构信息

1Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,450052,China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Feb;36(2):105-109. doi: 10.13201/j.issn.2096-7993.2022.02.006.

Abstract

The aim of this study is to evaluate the efficacy of unilateral posterior glottic cleft dilatation with low-temperature plasma under the endoscope in the treatment of bilateral vocal cord paralysis dyspnea. Forty-one patients with bilateral vocal cord paralysis were recruited, and they were all admitted to the Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Zhengzhou University from March 2014 to June 2019. Those 41 patients were all treated with low-temperature plasma to completely resect unilateral arytenoid cartilage and the posterior 1/3 of the ipsilateral vocal cord. Fiber laryngoscopy was performed before and after operation. The clinical efficacy of the operation was evaluated by the size of glottis cleta, the improvement rate of dyspnea, voice satisfaction, swallowing function, the tracheal cannula removal rate and postoperative complication rate. Forty-one patients were followed up for 24-88 months. The rate of one-pass extubation was 88.57%(31/35). The satisfaction rate of voice was 92.11%(35/38). The recovery rate of swallowing function was 97.56%(40/41). This study demonstrated that the application of low-temperature plasma in unilateral posterior glottic cleft dilatation could significantly improved the ventilation function of patients with bilateral vocal cord paralysis, with a reliable curative effect and a high extubation rate. It is a safe, reliable, simple and minimally invasive treatment option for the treatment of bilateral vocal cord paralysis.

摘要

本研究旨在评估内镜下低温等离子体单侧后声门裂扩张术治疗双侧声带麻痹性呼吸困难的疗效。选取41例双侧声带麻痹患者,均于2014年3月至2019年6月入住郑州大学第一附属医院耳鼻咽喉头颈外科。对这41例患者均采用低温等离子体完全切除单侧杓状软骨及同侧声带后1/3。术前及术后行纤维喉镜检查。通过声门裂大小、呼吸困难改善率、嗓音满意度、吞咽功能、气管套管拔除率及术后并发症发生率评估手术临床疗效。41例患者随访24 - 88个月。一次拔管率为88.57%(31/35)。嗓音满意度为92.11%(35/38)。吞咽功能恢复率为97.56%(40/41)。本研究表明,低温等离子体应用于单侧后声门裂扩张术可显著改善双侧声带麻痹患者的通气功能,疗效可靠,拔管率高。是治疗双侧声带麻痹安全、可靠、简便、微创的治疗选择。

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