表面麻醉纤维喉镜与全麻显微支撑喉镜下对不同类型声带息肉摘除的临床疗效分析

目的比较表面麻醉纤维喉镜与全麻显微支撑喉镜对不同类型声带息肉(VCP)摘除的临床疗效。方法以2007年11月至2012年10月芜湖市第一人民医院收治的164例VCP患者作为研究对象,按照随机数字表法分为两组,表麻纤维喉镜组66例,采用表面麻醉纤维喉镜下VCP摘除术(广基VCP27例、带蒂VCP39例),全麻显微支撑喉镜组98例,采用全麻显微支撑喉镜下VCP摘除术(广基VCP50例、带蒂VCP48例),比较两组治疗效果及术后随访期间并发症发生情况。结果表麻纤维喉镜组手术时间显著短于全麻显微支撑喉镜组(35.6±12.3)min vs(46.5±17.6)min,P<0.05]。全麻显微支撑喉镜组与表麻纤维喉镜组对带蒂VCP有效率差异无统计学意义(95.8%vs97.4%,P>0.05);但全麻显微支撑喉镜组对广基VCP有效率显著高于表麻纤维喉镜组(94.0%vs81.5%,P<0.05)。全麻显微支撑喉镜组不良并发症发生率与表麻纤维喉镜组比较,差异无统计学意义(7.1%vs 4.5%,P>0.05)。结论表麻纤维喉镜与全麻显微支撑喉镜下VCP摘除术各有优点及局限,临床上应综合考虑以选择最优的治疗方案。

I The Clinical Efficacy of Topical Anesthesia Fibrolaryngoscope and General Anesthesia Micro - laryngoscope for Different Types of Vocal Cord Polyp

Objective To compare the clinical efficacy of topical anesthesia fibrolaryngoscope and general anesthesia micro-laryngoscope for different types of vocal cord polyp （VCP）. Methods A total of 164 VCP patients in Wuhu City First People＇s Hospital from Nov. 2007 to Oct. 2012 were divided into two groups by random number table method. 66 patients underwent topical anesthesia fibrolaryngoscope VCP enucleatian（27 cases of sessile polyps,39 cases of pedunculated polyps） as topical anesthesia fibrolaryngoscope group. 98 cases of patient underwent general anesthesia micro-laryngoscope VCP microscopic excision （50 cases of sessile polyps,48 cases of peduneulated polyps） as general anesthesia micro-laryngoscope group. The therapeutic effect and complication rate during follow-up period were compared. Results Mean operative time of topical anesthesia fibrolaryngoscope group was significant lower than general anesthesia micro-laryngoscope group （35.6± 12.3 ） rain vs （46.5 ± 17.6） min, P 〈 0.05 ]. The pedicle VCP efficiency in general anesthesia fibrolaryngoscope group and topical anesthesia micro-laryngoscope group was not statistically significantly different（95.8% vs 97.4% ,P 〉 0.05 ）. But the sessile polyps VCP efficiency of the former was significantly higher than the latter（94.0% vs 81.5% ,P 〈0.05 ）. The complication rate of the two groups had no statistically sigrificant difference （7.1% vs 4.5 %, P 〉 0.05 ）. Conclusion The topical anesthesia fibrolaryngoscope and general anesthesia micro-laryngoscope VCP enucleation each has its own advantages and limitations, comprehensive considerations should be made clinically to select the best treatment options.