可视支撑喉内镜下喉功能性手术
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摘要
目的探讨可视支撑喉内镜下喉功能性手术的可行性。方法喉部良性疾病患者160例,随机等分为两组,即可视支撑喉内镜组(研究组)80例,传统显微镜支撑喉镜手术组(对照组)80例。手术显微器械相同,手术由同一人完成。对两组的手术时间、住院时间、发音恢复时间、手术常见并发症及疗效等方面进行统计分析。结果手术时间:研究组(11.38±4.65)min,对照组(20.72±3.23)min,二者比较差异具有统计学意义(P<0.01)。其他手术疗效、平均住院日及手术并发症等均无统计学意义(P>0.05)。结论可视支撑喉内镜功能性手术治疗结果和手术并发症与传统的显微镜功能性手术没有差别,而在手术时间、操作难度等方面具有优势,可视支撑喉内镜功能性手术是可行的。
Objective To explore the feasibility of functional laryngeal surgery under self-retaining laryngoscope and rigid telescope with video system. Methods 160 cases suffering from benign laryngeal tumors were randomly divided into two groups. 80 patients of the study group received minimally invasive surgery under self-retaining laryngoscope and rigid telescope with video system while those of the control group(n = 80) received microsurgery under surgical microscope. The operation time,hospital stay,phonation recovery time,surgical effect and complications were compared between the two groups. Results Statistical analysis showed that the operation time of the study group(11.38 ± 4.65 min) was significantly shorter than that of the control group(20.72 ± 3.23 min)(P < 0.01). The differences of other parameter between the two groups were all statistically insignificant(all P > 0.05). Conclusion With advantages of short operation time and less surgical difficulty,functional laryngeal surgery is feasible under self-retaining laryngoscope and rigid telescope with video system.
Objective To explore the feasibility of functional laryngeal surgery under self-retaining laryngoscope and rigid telescope with video system. Methods 160 cases suffering from benign laryngeal tumors were randomly divided into two groups. 80 patients of the study group received minimally invasive surgery under self-retaining laryngoscope and rigid telescope with video system while those of the control group(n = 80) received microsurgery under surgical microscope. The operation time,hospital stay,phonation recovery time,surgical effect and complications were compared between the two groups. Results Statistical analysis showed that the operation time of the study group(11.38 ± 4.65 min) was significantly shorter than that of the control group(20.72 ± 3.23 min)(P < 0.01). The differences of other parameter between the two groups were all statistically insignificant(all P > 0.05). Conclusion With advantages of short operation time and less surgical difficulty,functional laryngeal surgery is feasible under self-retaining laryngoscope and rigid telescope with video system.
引文
[1]高下,钱晓云,陈杰,等.支撑喉内窥镜下喉吸引旋切技术在喉功能性手术中的应用[J].听力学及言语疾病杂志,2004,12(4):274-275.Gao X,Qian XY,Chen J,et al.Application of power laryngeal shaver blade in functional operation of larynx with laryngoscope and rigid telescope with video system[J].Journal of Audiology and Speech Pathology,2004,12(4):274-275.
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[7]曹先有,程振安,朱平.内窥镜与显微镜下声带良性增生性病变切除术疗效比较[J].听力学及言语疾病杂志,2011,19(3):264-265.Cao XY,Cheng ZA,Zhu P.Comparison of the curative effect of benign hyperplastic diseases in the vocal cords under endoscope and microscope[J].Journal of Audiology and Speech Pathology,2011,19(3):264-265.
[8]李泽卿,王秋萍,王天友,等.喉内镜手术治疗喉部疾病的临床应用-介绍一种喉部微创外科技术[J].中国耳鼻咽喉颅底外科杂志,2002,8(4):234-236.Li ZQ,Wang QP,Wang TY,et al.Clinical application of laryngeal endoscopic surgery in the treatment of laryngeal diseases[J].Chinese Journal of Otorhinolaryngology-Skull Base Surgery,2002,8(4):234-236.
[9]刘德华.支撑喉镜联合内镜声带良性病变切除术66例疗效分析[J].听力学及言语疾病杂志,2011,19(5):474.Liu DH.The curative effect analysis of video-assisted rigid endoscopic laryngosurgery for 66 patients with benign lesion of the vocal cords[J].Journal of Audiology and Speech Pathology,2011,19(5):474.
[10]严行文,徐锡华,林燕子,等.支撑喉内镜下声带手术105例报告[J].中国微创外科杂志,2007,7(8):781.Yan XW,Xu XH,Lin YZ,et al.Report of vocal cord video-assisted rigid endoscopic laryngosurgery in 105 patients[J].Chinese Journal of Minimally Invasive Surgery,2007,7(8):781.
[11]秦茂林,刘业海,吴开乐,等.可调式支撑喉镜下声门暴露困难患者的喉显微外科手术[J].听力学及言语疾病杂志,2016,24(2):135-138.Qing ML,Liu YH,Wu KL,et al.Use of self-retaining laryngoscope in difficult laryngeal exposure in laryngeal microsurgery[J].Journal of Audiology and Speech Pathology,2016,24(2):135-138.
[12]黄章模,葛平江,陈少华,等.支撑喉镜下声带手术口咽部并发症的临床分析[J].中国耳鼻咽喉颅底外科杂志,2013,19(5):412-415.Huang ZM,Ge PJ,Chen SH,et al.Oropharyngeal complications of self-retaining laryngoscopic vocal surgery[J].Chinese Journal of Otorhinolaryngology-Skull Base Surgery,2013,19(5):412-415.
[13]马连山,董文会,李学昌,等.支撑喉镜声带息肉切除术后并发舌下神经麻痹[J].中华耳鼻咽喉头颈外科杂志,2006,41(5):323.Ma LS,Dong WH,Li XC,et al.Hypoglossal nerve palsy after supporting laryngoscopic vocal cord polypectomy[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2006,41(5):323.
[14]张旭,戴勇传.全麻支撑喉镜下显微声带手术的严重并发症及其处理[J].中国耳鼻咽喉颅底外科杂志,2015,21(5):416-417.Zhang X,Dai YC.Severe complications and their treatment in vocal cord microsurgery with self-retaining laryngoscope under general anesthesia[J].Chinese Journal of Otorhinolaryngology-Skull Base Surgery,2015,21(5):416-417.
[15]黄晨,莫江.影响显微支撑喉镜下声门暴露的相关因素研究[J].中国耳鼻咽喉颅底外科杂志,2016,22(4):317-319,322.Huang C,Mo J.Study on affect factors related to laryngeal exposure in self-retaining microscopic surgery[J].Chinese Journal of Otorhinolaryngology-Skull Base Surgery,2016,22(4):317-319,322.
[2]Kawaida M,Fukuda H,Kohno N.Video-assisted rigid endoscopic laryngosurgery:application to cases with difficult laryngeal exposure[J].J Voice,2001,15(2):305-312.
[3]单希征,龙顺波,孙铭钏,等.支撑喉内镜电视显示系统下手术治疗喉部病变[J].中华耳鼻咽喉科杂志,2004,39(1):43.Shan XZ,Long SB,Shun MC,et al.Surgical treatment of laryngeal diseases under laryngoscope and rigid telescope with video system[J].Chinese Journal of Otorhinolarygology,2004,39(1):43.
[4]刘波,周长华,熊虹泉,等.不同内镜下手术治疗声带息肉110例疗效比较[J].实用临床医药杂志,2016,20(7):150-151.Liu B,Zhou CH,Xiong HQ,et al.Therapeutic effect comparison of vocal cord polyp with different endoscopic surgeries in 110 cases[J].Journal of Clinical Medicine in Practice,2016,20(7):150-151.
[5]李进让,孙建军.声带任克水肿[J].中国耳鼻咽喉头颈外科杂志,2006,13(1):60-61.Li JR,Sun JJ.Reinke's edema[J].Chinese Archives of Otolaryngology-Head and Neck Surgery,2006,13(1):60-61.
[6]鲁茂松,童步升.电视支撑喉内镜下声带息肉手术治疗的疗效观察[J].中国中西医结合耳鼻咽喉科杂志,2015,23(1):61-62.Lu MS,Tong BS.Surgical effect of vocal cord polyps under laryngoscope and rigid telescope with video system[J].Chinese Journal of Otorhinolaryngology in Integrative Medicine,2015,23(1):61-62.
[7]曹先有,程振安,朱平.内窥镜与显微镜下声带良性增生性病变切除术疗效比较[J].听力学及言语疾病杂志,2011,19(3):264-265.Cao XY,Cheng ZA,Zhu P.Comparison of the curative effect of benign hyperplastic diseases in the vocal cords under endoscope and microscope[J].Journal of Audiology and Speech Pathology,2011,19(3):264-265.
[8]李泽卿,王秋萍,王天友,等.喉内镜手术治疗喉部疾病的临床应用-介绍一种喉部微创外科技术[J].中国耳鼻咽喉颅底外科杂志,2002,8(4):234-236.Li ZQ,Wang QP,Wang TY,et al.Clinical application of laryngeal endoscopic surgery in the treatment of laryngeal diseases[J].Chinese Journal of Otorhinolaryngology-Skull Base Surgery,2002,8(4):234-236.
[9]刘德华.支撑喉镜联合内镜声带良性病变切除术66例疗效分析[J].听力学及言语疾病杂志,2011,19(5):474.Liu DH.The curative effect analysis of video-assisted rigid endoscopic laryngosurgery for 66 patients with benign lesion of the vocal cords[J].Journal of Audiology and Speech Pathology,2011,19(5):474.
[10]严行文,徐锡华,林燕子,等.支撑喉内镜下声带手术105例报告[J].中国微创外科杂志,2007,7(8):781.Yan XW,Xu XH,Lin YZ,et al.Report of vocal cord video-assisted rigid endoscopic laryngosurgery in 105 patients[J].Chinese Journal of Minimally Invasive Surgery,2007,7(8):781.
[11]秦茂林,刘业海,吴开乐,等.可调式支撑喉镜下声门暴露困难患者的喉显微外科手术[J].听力学及言语疾病杂志,2016,24(2):135-138.Qing ML,Liu YH,Wu KL,et al.Use of self-retaining laryngoscope in difficult laryngeal exposure in laryngeal microsurgery[J].Journal of Audiology and Speech Pathology,2016,24(2):135-138.
[12]黄章模,葛平江,陈少华,等.支撑喉镜下声带手术口咽部并发症的临床分析[J].中国耳鼻咽喉颅底外科杂志,2013,19(5):412-415.Huang ZM,Ge PJ,Chen SH,et al.Oropharyngeal complications of self-retaining laryngoscopic vocal surgery[J].Chinese Journal of Otorhinolaryngology-Skull Base Surgery,2013,19(5):412-415.
[13]马连山,董文会,李学昌,等.支撑喉镜声带息肉切除术后并发舌下神经麻痹[J].中华耳鼻咽喉头颈外科杂志,2006,41(5):323.Ma LS,Dong WH,Li XC,et al.Hypoglossal nerve palsy after supporting laryngoscopic vocal cord polypectomy[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2006,41(5):323.
[14]张旭,戴勇传.全麻支撑喉镜下显微声带手术的严重并发症及其处理[J].中国耳鼻咽喉颅底外科杂志,2015,21(5):416-417.Zhang X,Dai YC.Severe complications and their treatment in vocal cord microsurgery with self-retaining laryngoscope under general anesthesia[J].Chinese Journal of Otorhinolaryngology-Skull Base Surgery,2015,21(5):416-417.
[15]黄晨,莫江.影响显微支撑喉镜下声门暴露的相关因素研究[J].中国耳鼻咽喉颅底外科杂志,2016,22(4):317-319,322.Huang C,Mo J.Study on affect factors related to laryngeal exposure in self-retaining microscopic surgery[J].Chinese Journal of Otorhinolaryngology-Skull Base Surgery,2016,22(4):317-319,322.
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