支撑喉镜电视内镜下低温等离子射频治疗会厌囊肿的疗效研究

目的探讨支撑喉镜电视内镜下低温等离子射频治疗会厌囊肿的疗效及其对术后近期复发率的影响。方法选取因会厌囊肿拟行择期手术患者116例,以患者收治顺序分为观察组与对照组,每组各58例。对照组采用传统手术切除,观察组在支撑喉镜电视内镜下行低温等离子射频消融治疗。比较两组围手术期情况,术前及术后7d会厌囊肿评分,病理类型以及并发症,随访12个月观察复发情况。结果两组均一次手术成功,新生物切除干净;观察组手术时间、术中及术后出血量均少于对照组(P0.05或P0.01)。观察组和对照组患者术前厌囊肿评分为5.5±1.0和5.4±1.2,两组患者比较无统计学差异(P0.05),术后7d两组会厌囊肿评分术后分别为0.6±0.2及1.8±0.5,两组评分与术前比较均显著降低(P0.01),且观察组术后会厌囊肿评分低于对照组(P0.05)。病理类型主要为粘液囊肿、表皮样囊肿,差异无统计学意义(P0.05)。除观察组2例、对照组3例患者有轻微异物感外,未见其他并发症。术后1年,观察组与对照组复发率分别为1.72%(1/58)和8.62%(5/58),差异具有统计学意义(P0.05)。结论经支撑喉镜电视内镜下低温等离子射频治疗会厌囊肿具有较好的临床疗效,术中能精确切割病变组织,且无热效应损伤周围组织,术中出血量少,术后恢复迅速,且近期复发率较低,是一种安全、有效的微创治疗方法。

Curative Effect on Epiglottic Cyst by Low-temperature Plasma Radiofrequency Ablation under Support Laryngoscope with Endoscope

Objective To explore the curative effect on epiglottic cyst by low-temperature plasma radio- frequency ablation under support laryngoscope with endoscope. Methods 116 cases with epiglottic cysts un- dergoing elective operation were selected, and were divided into observation group and control group, 58 cases each. Patients in control group were given traditional resection, and patients in observation group were given low-temperature plasma radiofrequency ablation under support laryngoscope with endoscope. The perioperative period situation, epiglottic cysts score before and 7 days after operation, pathological type,complications and the recurrence in 12 months between the two groups were compared. Results The procedures were successful, and all neoplasms were removed. The operation time, intraoperative and postoperative bleeding in observation group were less than that in the control group（P 〈0.05 or P 〈0.01 ）. The score of epiglottic cysts 7 days after opera- tion were 0.6 ± 0.2 and 1.8 ± 0.5 respectively, and both decreased comparing with pre-operation （ P 〈 0.01 ）. And the score of epiglottic cysts of the observation group was less than that of control group（P 〈0.05）. Mucous cysts and epidermoid cysts were the main pathologic type, and there was no statistical difference between the two groups （P 〉 0.05）. Except for mild foreign body sensation of 2 cases in observation group and 3 cases in control group, there was no other complication. The one-year recurrence rate of the observation group and the con- trol group was 1.72% and 8.62% respectively（ P 〈 0.05 ）. Conclusion It has better curative effect of epiglottic cyst by low-temperature plasma radiofrequency ablation under support laryngoscope with endo- scope, and it can cut off lesions accurately with less peripheral tissue damage by thermal effect, and also it has less bleeding, rapid recovery, and low recurrence rate, so is a safe and effective method in minimally invasive treatment.