低温等离子射频消融与CO2激光对喉癌前病变患者嗓音功能的影响

目的 比较低温等离子射频消融术与CO₂激光治疗对喉癌前病变患者嗓音功能的影响。 方法 选取2014年9月—2018年3月接受治疗的83例喉癌前病变患者作为研究对象，根据随机数字法将其分为2组，其中观察组42例，对照组41例。对照组给予CO₂激光治疗，观察组给予低温等离子射频消融术治疗。治疗后，比较2组手术时间、住院时间、术后1 d疼痛评分(VAS评分)、术后1个月黏膜恢复情况评分、基频(F0)、基频微扰(Jitter)、振幅微扰(Shimmer)、标准化噪声能量(NNE)等嗓音功能的变化以及术后并发症的发生情况。 结果 观察组住院时间、术后1 d疼痛评分与对照组比较差异无统计学意义(均P>0.05)，但手术时间短，黏膜恢复好，与对照组比较差异有统计学意义(均P<0.05)。治疗后，2组F0、Jitter、Shimmer及NNE水平均显著降低(均P<0.05)，观察组F0水平与对照组比较差异无统计学意义(P>0.05)，观察组Jitter、Shimmer及NNE水平低于对照组(均P<0.05)。2组患者均无发声困难、呼吸困难以及声带粘连等并发症发生，观察组无复发患者，对照组有2例复发，再经CO₂激光治疗后恢复。 结论 相较于CO₂激光治疗而言，低温等离子射频消融术治疗喉癌前病变近期疗效更为显著，可有效缩短手术时间，尽快促进患者黏膜及嗓音功能的恢复。 

Effects comparison of low temperature plasma radiofrequency ablation and CO2 laser treatment on voice function of patients with laryngeal precancerous lesions

Objective To compare the effect of low temperature plasma radiofrequency ablation and CO₂ laser treatment on voice function of patients with laryngeal precancerous lesions. Methods A total of 83 patients with laryngeal precancerous lesions treated in our hospital from September 2014 to March 2018 were selected as subjects, and divided into two groups according to random number method, and 42 patients in observation group and 41 patients in control group. The control group was treated with CO₂ laser, and the observation group was treated with low temperature plasma radiofrequency ablation. After treatment, the operation time, hospitalization time, postoperative 1 day pain score (VAS score), postoperative 1 month mucosal recovery score and other surgical related indicators were compared with the postoperative 1 month fundamental frequency (F0), base frequency micro Changes in arpeggio functions such as jitter, amplitude perturbation (Shimmer), standardized noise energy (NNE), and postoperative complications. Results There was no significant difference on hospitalization time, and postoperative 1 day pain score between the observation group and the control group (all P>0.05). However, the operation time and mucosal recovery scores after surgery 1 month of observation group were significantly lower than those of control group (all P<0.05). After treatment, the F0, Jitter, Shimmer and NNE of two groups were significantly reduced (all P<0.05), However, there was no significant difference on F0 level between the two groups (P>0.05), and Jitter, Shimmer and NNE of observation group were lower than those of control group (P<0.05). There were no complications such as dysphonia, dyspnea and vocal cord adhesion in the two groups. There were no recurrence in the observation group, and 2 cases in the control group relapsed and then recovered after CO₂ laser treatment. Conclusion Compared with CO₂ laser treatment, low-temperature plasma radiofrequency ablation is more effective in the treatment of laryngeal precancerous lesions, which can effectively shorten the operation time and promote the recovery of mucosal and voice function as soon as possible.