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目的 探讨声带癌T1 的CO2 激光治疗与放射治疗对喉发声机能有何不同影响。方法 2 4例声带癌T1 患者 ,9例行CO2 激光治疗 ,7例放射治疗 ,8例CO2 激光与放射联合治疗。于治疗前后行频闪喉镜检查 ,嗓音声学分析 (APQ ,PPQ ,NNEb ,NNEa) ,喉平均呼气流率 (MFR)检测及嗓音听觉评价分析。结果 放射加激光联合治疗对发声功能较单独应用激光或单独应用放射的影响大。CO2 激光治疗组嗓音音质改变以粗糙型、气息型为主 ,放射治疗组以粗糙型、气息型、紧张型为主。频闪喉镜检查见CO2 激光治疗患者及部分放射患者出现声门闭合不全 ,声带振动振幅减小 ,声带粘膜波减弱或消失。喉平均呼气流率在CO2 激光、放射及激光加放射联合治疗组间未见统计学显著性差异。结论 用CO2 激光与放射疗法对声带癌T1 治疗对喉发声机能的影响无统计学显著性差异。考虑到放射的周期长 ,副作用多等缺点 ,认为对声带癌T1 患者应用CO2 激光治疗将有更多的优越性
Objective To explore the different effects of CO2 laser treatment and radiotherapy on vocal function of vocal cord cancer T1. Methods Twenty-four patients with T1 vocal cord cancer were treated with CO2 laser, 7 with radiotherapy and 8 with CO2 laser and radiotherapy. Before and after treatment, the laryngoscope examination, voice acoustics analysis (APQ, PPQ, NNEb, NNEa), laryngeal mean expiratory flow rate (MFR) and voice auditory evaluation were analyzed. Results Radiofrequency laser combined therapy had a greater impact on sounding than either laser alone or radiation alone. CO2 laser treatment group voice quality changes to rough, breath-based, radiotherapy group to rough, breath-based, stress-based. Filament laryngoscopy in patients with CO2 laser treatment and partial radiation patients with glottis insufficiency, vocal cord vibration amplitude decreases, vocal cord mucosal wave weakened or disappeared. Mean laryngopharyngeal flow rate was not significantly different between CO 2 laser, radiation and laser plus radiation combined treatment groups. Conclusion CO2 laser and radiotherapy for vocal cord cancer T1 treatment on the laryngeal sound function no significant difference. Taking into account the long cycle of radiation, side effects and other shortcomings, that the application of CO2 laser in patients with vocal cord cancer T1 will have more advantages