CO2 激光切除术与喉显微手术治疗声带息肉的临床疗效及嗓音效果分析。
Analysis of the clinical efficacy and voice outcomes of CO laser resection versus laryngeal microsurgery for vocal cord polyps.
机构信息
Department of Otolaryngology, Zhumadian Central Hospital of Henan Province, Zhumadian, China.
出版信息
Ann Med. 2023;55(2):2280228. doi: 10.1080/07853890.2023.2280228. Epub 2023 Nov 27.
OBJECTIVE
To compare CO laser resection and laryngeal microsurgery for vocal cord polyps and provide evidence for the optimal surgical method.
METHODS
This was a retrospective cohort study that included 74 patients with vocal cord polyps who underwent either CO laser resection or laryngeal microsurgery in our hospital from August 2018 to December 2021. According to their preference, 77 patients were divided into two groups: a CO laser resection group ( = 35) and a laryngeal microsurgery group ( = 39). Patients were evaluated two days before surgery, and follow-ups were conducted one, two and four weeks after surgery. The voice handicap index (VHI-10) score, voice acoustic analysis results and electronic laryngoscopy results were collected for each patient, and the differences between the two groups were evaluated.
RESULTS
The basic demographic characteristics of the 74 patients were comparable, and all patients completed postoperative follow-up observations. A total of 30 (85.71%) patients in the CO laser resection group and 22 (56.41%) patients in the laryngeal microsurgery group were healed. The total effectiveness rate of the CO laser resection group (94.29%) was significantly higher than that of the laryngeal microsurgery group (82.05%), and the difference between the two groups was statistically significant ( = .037). Both surgical methods had a positive effect on reducing VHI-10 scores with the effect of CO laser resection being more obvious. The difference between the two groups in this regard was statistically significant ( < .001). The effects of each surgical method on the average fundamental frequency perturbation (jitter), amplitude perturbation (shimmer), maximum phonation time and dysphonia severity index were not statistically significant ( > .05).
CONCLUSION
CO laser resection and laryngeal microsurgery have similar effects on voice quality, but CO laser resection has higher clinical efficacy.
目的
比较 CO2 激光切除术与喉显微手术治疗声带息肉的疗效，为临床选择最佳手术方式提供依据。
方法
本研究为回顾性队列研究，纳入 2018 年 8 月至 2021 年 12 月于我院行 CO2 激光切除术或喉显微手术治疗的声带息肉患者 74 例。根据患者意愿将其分为 CO2 激光切除术组（35 例）和喉显微手术组（39 例）。分别于术前 2 天、术后 1、2、4 周对患者进行评估，采集嗓音障碍指数（VHI-10）评分、嗓音声学分析结果及电子喉镜结果，比较两组间差异。
结果
74 例患者的基本人口学特征比较，均完成术后随访观察。CO2 激光切除术组患者术后痊愈 30 例（85.71%），喉显微手术组痊愈 22 例（56.41%），CO2 激光切除术组总有效率（94.29%）明显高于喉显微手术组（82.05%），差异有统计学意义（ = .037）。两种手术方式均可有效降低 VHI-10 评分，且 CO2 激光切除术的效果更为明显，差异有统计学意义（ < .001）。两种手术方式对平均基频微扰（jitter）、振幅微扰（shimmer）、最长发声时间及嗓音障碍严重指数的影响差异无统计学意义（ > .05）。
结论
CO2 激光切除术与喉显微手术治疗声带息肉的疗效相似，但 CO2 激光切除术的临床疗效更高。
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