低温等离子消融术治疗早期声门型喉癌的疗效分析

目的 分析低温等离子消融手术治疗早期声门型喉癌的近期疗效与安全性。 方法 选取2007年3月—2012年2月诊治的早期声门型喉癌患者93例，行低温等离子切除术43例，行喉部分切开术50例，统计2组患者的术后复发、并发症及短期生存率等情况。 结果 低温等离子切除患者中有2例复发，分别为T1b、T2，喉部分切除患者中共有5例患者复发，分别为Tis期1例、T1a期3例、T2期1例，2组间复发情况发生率差异不具有统计学意义(χ2=0.950,P=0.329)；行低温等离子切除患者仅有1例出现吞咽及呼吸障碍；而喉部分切除患者中切口感染5例、咽漏3例、吞咽及呼吸障碍4例，差异具有统计学意义(χ2=9.032,P=0.003)；研究随访3年，对所有患者进行生存状况统计显示，低温等离子组中5例(11.63%)患者病情进展死亡，T1b期2例(4.65%)、T2期3例(6.98%)；喉部分切除术组死亡7例(18.00%)，其中T1a期2例(4.00%)、T1b期2例(4.00%)、T2期3例(6.00%)。2组间生存率差异不具有统计学意义(χ2=1.758,0.035,0.734,P＞0.05)。 结论 低温等离子消融术在治疗早期声门型喉癌中，组织损伤较轻，且并发症少，能够保证患者术后的生活质量，是早期声门型喉癌较理想的治疗选择，值得临床推广。 

Effect of low-temperature plasma ablation in the treatment of early glottic cancer

Objective To analysis the short-term efficacy and safety of low-temperature plasma ablation in the treatment of early glottic carcinoma. Methods Total 93 cases of early glottic carcinoma in our hospital from March 2007 to February 2012 were enrolled into this study.Total 43 cases underwent the low-temperature plasma ablation,while 50 cases underwent the partial laryngectomy.The recurrence rate,incidence of complications and short-term survival rate of patients were compared between the two groups. Results There were 2 cases of postoperative recurrence(stage T1b and T2,one case for each stage) in the low-temperature plasma ablation group,and 5 cases(1 case of Tis,3 cases of T1a and 1 case of T2) in the partial laryngectomy group.There was no statistical difference in the recurrence rate between the two groups(χ2=0.950,P=0.329).There was 1 case of swallowing and breathing disorders in the low-temperature plasma ablation group,while there were 5 cases of incision infection,3 cases of pharyngeal fistula and 4 cases of swallowing and breathing disorders in the partial laryngectomy group,the difference in the incidence of complications was statistically significant between two groups(χ2=9.032,P=0.003).The follow-up of 3 years showed that 5 cases in the low-temperature plasma ablation group died,including 2 cases of T1b and 3 cases of T2;while 7 cases in the partial laryngectomy group died,including 3 cases of T2,2 cases of T1a and 2 cases of T1b.The difference in survival between the two groups was not statistically significant(χ2=1.758,0.035,0.734,P＞0.05). Conclusion There was slight tissue injury and fewer complications in the treatment of early glottic laryngeal cancer by the low temperature plasma ablation,and ensure the quality of life of patients after the operation,which is an ideal options for the patients with early glottic laryngeal cancer.