Effect observation of nasal endoscopy combined with laryngeal dynamic system in treatment of benign vocal cord lesions patients with difficulty of glottis exposure
-
摘要: 目的 探讨鼻内镜联合喉动力系统治疗声门暴露困难的声带良性病变患者的效果。 方法 选取84例声门暴露困难的声带良性病变患者,根据手术方式分为2组。观察组(n=50)采用鼻内镜与支撑喉镜喉动力系统进行手术切除,对照组(n=34)采用常规支撑喉镜显微手术。比较2组患者的手术时间、临床疗效、并发症发生率等指标。 结果 观察组手术时间为(44.62±10.25)min, 显著短于对照组的(50.39±13.34)min(P<0.05)。2组患者术前嗓音障碍指数-10(VHI)量表各维度评分及总评分无显著差异(P>0.05); 与术前相比, 2组术后4周的VHI各维度评分及总评分均降低,且观察组降低幅度更大,差异有统计学意义(P<0.05)。观察组术后并发症总发生率为10.00%, 显著低于对照组的23.53%(P<0.05)。观察组总有效率为98.00%, 显著高于对照组的82.35%(P<0.05); 观察组治愈率为90.00%, 显著高于对照组的58.82%(P<0.05)。 结论 鼻内镜联合喉动力系统治疗声门暴露困难的声带良性病变患者安全、有效,具有视野清晰、操作简单、创伤小、并发症少、治愈率高等优点。Abstract: Objective To investigate the effect of nasal endoscopy combined with laryngeal dynamic system in the treatment of benign vocal cord lesions patients with difficulty of glottis exposure. Methods A total of 84 vocal cord benign lesions patients with difficulty of glottis exposure were divided into two groups according to surgical methods. The observation group(n=50)was treated by laryngeal dynamic system resection under nasal endoscopy and support laryngoscope, while the control group(n=34)was treated with conventional support laryngoscope microsurgery. The operation time, clinical efficacy and incidence of complications were compared between the two groups. Results The operation time of the observation group was(44.62±10.25)min, which was significantly shorter than(50.39±13.34)min of the control group(P<0.05). There were no significant differences in the score of each item and the total score of voice disorder index-10(VHI)scale before operation between the two groups(P>0.05). Compared with scores before operation, the score of each item and the total score of VHI decreased significantly at 4 weeks after the operation in both groups, and the decrease range of the observation group was significantly greater than that of the control group(P<0.05). The total incidence of postoperative complications in the observation group was 10.00%, which was significantly lower than 23.53% in the control group(P<0.05). The total - effective rate of the observation group was 98.00%, which was significantly higher than 82.35% of the control group(P<0.05). The cure rate of the observation group was 90.00%, which was significantly higher than 58.82% of the control group(P<0.05). Conclusion Nasal endoscopy combined with laryngeal dynamic system is safe and effective in the treatment of vocal cord benign lesions patients with difficulty of glottis exposure, which has the advantages of clear vision, simple operation, less trauma, less complications and high cure rate.
-
-
郭文俊, 何霞, 郝红丽, 等. 声带息肉诊断与治疗[J]. 国际耳鼻咽喉头颈外科杂志, 2017, 41(5): 254-257. 孙柳, 杨长亮, 阳光, 等. 支撑喉镜-鼻内镜下切除暴露困难声带良性病变的应用[J]. 华南国防医学杂志, 2017, 31(2): 133-134. 徐文, 李红艳, 胡蓉, 等. 嗓音障碍指数量表中文版信度和效度评价[J]. 中华耳鼻咽喉头颈外科杂志, 2008, 43(9): 670-675. 周红宇, 李艳妮, 许戈, 等. 儿童良性增生性声带疾病手术疗效的嗓音声学分析[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(13): 1003-1005. 袁勇, 冯肖连, 张中宝, 等. 支撑喉镜结合电子喉镜切除声门暴露困难的声带良性肿物60例[J]. 海南医学, 2017, 28(5): 828-830. 郑金山. 70 °鼻内镜在咽喉科临床诊疗中的应用[J]. 华西医学, 2017, 32(4): 584-585. 马利娟, 汤夏冰, 魏新民. 支撑喉镜联合鼻内镜与纤维喉镜下切除声带息肉临床对比分析[J]. 现代中西医结合杂志, 2017, 26(6): 608-610. 倪敏. 经鼻内镜下美敦力耳鼻咽喉动力系统治疗慢性鼻窦炎鼻息肉的疗效及安全性分析[J]. 临床和实验医学杂志, 2015, 14(7): 585-587. 毕致, 肖锋, 朱鹃芬. 侧开式喉镜下喉动力系统切除会厌囊肿46例[J]. 山东大学耳鼻喉眼学报, 2016, 30(3): 111-112. Li L J, Wang L, Du C, et al. Application of endoscope assisted curved laryngoscope in laryngeal microsurgery of patients with difficulty laryngeal exposure[J]. J Clin Otorhinolaryngol Head Neck Surg, 2018, 32(4): 282-284.
张恩柱, 汤凌浩, 吕梅, 等. 鼻内镜下腺样体手术两种不同术式的疗效比较[J]. 大连医科大学学报, 2016, 38(4): 374-376. 周亚权. 支撑喉镜联合鼻内镜治疗暴露困难的声带良性病变28例[J]. 江苏医药, 2016, 42(10): 1195-1196. Saibene A M, Pipolo C, Lorusso R, et al. Transnasal endoscopic microfractured fat injection in glottic insufficiency[J]. B-ENT, 2015, 11(3): 229-234.
Arens C, Piazza C, Andrea M, et al. Proposal for a descriptive guideline of vascular changes in lesions of the vocal folds by the committee on endoscopic laryngeal imaging of the European Laryngological Society[J]. Eur Arch Otorhinolaryngol, 2016, 273(5): 1207-1214.
Matievics V, Bach A, Sztano B, et al. Functional outcomes of endoscopic arytenoid abduction lateropexy for unilateral vocal cord paralysis with dyspnea[J]. Eur Arch Otorhinolaryngol, 2017, 274(10): 3703-3710.
-
期刊类型引用(3)
1. 王慧蓉，张净瑶，顾雅博. 鼻内镜下动力系统治疗慢性鼻-鼻窦炎伴鼻息肉的疗效. 巴楚医学. 2023(01): 95-99 . 
百度学术
2. 田文浩. 直接喉镜联合30℃5mm长腹腔镜在声门暴露困难手术患者中的应用. 医学理论与实践. 2022(10): 1701-1703 . 百度学术
3. 林姗姗，彭韶平. 支撑喉镜下声带手术暴露困难的处理方法. 中国医学文摘(耳鼻咽喉科学). 2021(05): 149-151+159 . 百度学术
其他类型引用(0)
计量
- 文章访问数: 328
- HTML全文浏览量: 104
- PDF下载量: 8
- 被引次数: 3
下载:
苏公网安备 32100302010246号