徐嘉 溫延輝 謝曉梅

[摘要] 目的 研究比較支撐喉鏡下二氧化碳激光切除術(shù)以及常規(guī)切除術(shù)治療聲帶息肉的臨床效果。方法 方便選取該院2017年8月—2018年10月收治的聲帶息肉的患者83例，隨機數(shù)字法分為兩組，觀察組患者42例，對照組患者41例，觀察組患者進行支撐喉鏡下二氧化碳激光切除術(shù)治療，對照組患者進行支撐喉鏡下常規(guī)切除治療。治療結(jié)束后，觀察比較兩組患者的聲帶恢復(fù)情況、兩組患者的嗓音學變化的指標以及兩組患者的不良反應(yīng)情況。 結(jié)果 觀察組患者的住院康復(fù)時間、完全恢復(fù)時間以及初次發(fā)聲時間較對照組患者顯著降低，差異有統(tǒng)計學意義（t=21.120、26.591、16.341，P<0.05）。觀察組患者的頻率微擾比率、標準化噪聲能量、諧噪比、振幅微擾及基頻等嗓音學指標變化顯著優(yōu)于對照組患者，差異有統(tǒng)計學意義（t=11.481、8.892、8.420、9.970、5.210，P<0.05）觀察組患者的治療有效率（97.61%）顯著高于對照組患者（80.48%），差異有統(tǒng)計學意義（χ2=6.298，P<0.05）。兩組患者的不良反應(yīng)發(fā)生率比較差異無統(tǒng)計學意義（χ2=0.608，P>0.05）。結(jié)論 支撐喉鏡下二氧化碳激光切除術(shù)和常規(guī)切除術(shù)均可治療聲帶息肉，手術(shù)均較安全，但是使用二氧化碳激光切除的聲帶恢復(fù)更快，聲帶功能恢復(fù)的更好。

[關(guān)鍵詞] 支撐喉鏡下二氧化碳激光切除術(shù);初次發(fā)聲時間;聲帶息肉;嗓音學

[中圖分類號] R767.4? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 1674-0742（2019）04（c）-0070-03

[Abstract] Objective To study and compare the clinical effects of carbon dioxide laser resection and conventional resection under self-retaining laryngoscope in the treatment of vocal cord polyps. Methods A total of 83 patients with vocal cord polyps admitted to our hospital from August 2017 to October 2018 were randomly divided into two groups， 42 patients in the observation group and 41 patients in the control group. The patients in the observation group were treated with carbon dioxide laser resection under the support laryngoscope， while the patients in the control group were treated with conventional resection under the support laryngoscope. After treatment， vocal cord recovery， voice changes and adverse reactions were observed and compared between the two groups. Results The inpatient rehabilitation time， complete recovery time， and initial vocalization time of the observation group were significantly shorter than those of the control group， and the difference was statistically significant （t=21.120， 26.591， 16.341， P<0.05）. The frequency perturbation ratio， standardized noise energy， harmonic noise ratio， amplitude perturbation and fundamental frequency of the observation group were significantly better than those of the control group， and the difference was statistically significant （t=11.481， 8.892， 8.420， 9.970， 5.210， P<0.05）. The effective rate of the observation group （97.61%） was significantly higher than that of the control group （80.48%）， and the difference was statistically significant （χ2=6.298，P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （χ2=0.608，P>0.05）. Conclusion Carbon dioxide laser resection and conventional laryngoscope resection can treat vocal cord polyps. Both of the two methods are is safer. But the recovery of vocal cord after carbon dioxide laser resection is faster and the recovery of vocal cord function is better.