不同术式治疗T1a期声门型喉癌的嗓音功能评估

Voice Analysis after Transoral Laser Cordectomy and Radiofrequency Coblation Therapy for T1a Glottic Cancer

王燕;屈季宁;周涛;华清泉;雷薇薇;舒婧

1:武汉大学人民医院耳鼻咽喉头颈外科

摘要

目的对比CO_2激光、低温等离子刀切除术两种术式治疗早期声门型喉癌的嗓音恢复情况。方法回顾性分析2017年1月～2019年12月在武汉大学人民医院进行CO_2激光和等离子刀切除术治疗的42例T1aN0M0期声门型喉癌患者的临床资料，分为两组，A组20例，采用低温等离子刀切除术治疗；B组22例，采用CO_2激光切除术治疗。根据病变范围，按内镜下声带切除术分类标准指南，40例患者采用Ⅲ型手术，2例采用Ⅳ型手术。术中取切缘进行冰冻病理检查，阴性即可结束手术。手术前及术后3、6、9及12个月应用嗓音障碍指数VHI-10、听感知评估GRABS及多维嗓音分析软件对患者嗓音功能进行评估，动态喉镜检查观察声带形态及黏膜波，比较两组结果。结果 (1)两组患者术后3个月时，jitter、shimmer及NHR数值明显增高，随着时间推移，jitter、shimmer及NHR数值逐渐降低，到9个月以后，以上观察指标趋于稳定。(2)术后9个月时，B组嗓音功能恢复优于A组。主观听感知方面，B组术后嗓音障碍程度轻于A组；两组间jitter值差异有统计学意义(P<0.05)。(3)动态喉镜检查：B组术后声带闭合、运动的对称性、黏膜波、振动规律性优于A组(P<0.05)。结论对T1a期声门型喉癌患者，CO_2激光术后患者嗓音功能恢复情况优于低温等离子射频手术。

关键词

声门型喉癌;CO_2激光;等离子刀;嗓音功能

基金项目(Foundation):

作者

王燕;屈季宁;周涛;华清泉;雷薇薇;舒婧

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声门型喉癌 CO_2激光等离子刀嗓音功能

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王燕屈季宁周涛华清泉雷薇薇舒婧