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目的:探讨内镜辅助支撑喉镜下应用喉吸切钻切除青少年型复发性呼吸道乳头状瘤(JO-RRP)的优点。方法:将肿物的严重程度分为3级(轻度1分,中度2分,重度3分),评价22个呼吸和消化道的解剖亚区,计算总积分及声门区病变积分并分组。内镜辅助支撑喉镜下,应用喉吸切钻或显微喉钳切除全部乳头状瘤。比较同积分组病例应用两种处理方式在手术时间、手术间期、术后近期声音质量、术后疤痕形成、术后气管切开及再次手术时肿瘤分布等方面的差别。结果:33例患儿,应用喉吸切钻14例,单纯摘除有19例,共进行了142次手术,喉吸切钻组较单纯摘除组的手术时间短、手术间期长、术后近期声音质量的改善明显,且不易引起新生疤痕或肿瘤分布扩大,有统计学意义;单纯摘除组有2例需术后气管切开;喉吸切钻组未见类似现象。结论:应用喉吸切钻处理JO-RRP,有操作简单,方便,术野清晰,切除精确,创伤小,并发症少,术后近期声音质量较好、恢复快及手术间期长等优点。
Objective: To investigate the advantages of endoscopic laryngoscope assisted laryngotomy for the treatment of recurrent respiratory papilloma (JO-RRP). Methods: The severity of tumor was divided into three grades (mild 1, moderate 2, severe 3), 22 anatomical subsets of respiration and digestive tract were evaluated, and the total score and glottis area were calculated. Grouping. Endoscopic assisted laryngoscope, the application of laryngeal suction drill or microlaryngeal forceps removal of all papilloma. The differences between the two groups were compared in terms of operation time, operation period, postoperative short-term sound quality, postoperative scar formation, postoperative tracheotomy and re-operation tumor distribution. Results: In 33 cases, 14 cases were treated with laryngeal suction drilling, 19 cases were simply excised, and 142 operations were performed. Laryngeal suction drill group had shorter operative time, longer operative period and shorter postoperative period The improvement of the sound quality was obvious, and it was not easy to cause the newborn scar or the distribution of the tumor to enlarge, which was statistically significant. There were 2 cases needing tracheotomy in the simple enucleation group and no similar phenomenon in the laryngeal suction cutting group. Conclusion: The application of laryngeal suction drilling for the treatment of JO-RRP has the advantages of simple and convenient operation, clear surgical field, accurate excision, less trauma, less complications, better sound quality in the near future, faster recovery and longer operative period.