等离子射频消融术治疗老年早期声门型喉癌的远期疗效及其对嗓音声学影响

目的　探究等离子射频消融术治疗老年早期声门型喉癌（early glottic cancer，EGC）的远期疗效及其对嗓音声学的影响。 方法 回顾性分析2010年5月~2011年5月河南省人民医院耳鼻咽喉头颈外科收治的95例EGC患者临床资料，根据治疗方案的不同将其分为研究组和对照组，对照组46例行CO2激光切除术，研究组49例行等离子射频消融术治疗，比较两组视觉模拟评分（visual analogue scale，VAS）、临床疗效总有效率、嗓音学指标（基频微扰、标准化噪声能量、振幅微扰）、术后生活质量（躯体疼痛、生理功能、生理职能、总体健康评分）及远期疗效（5年生存率、局部复发率）。 结果 VAS评分研究组较对照组无统计学差异（P>0.05）；总有效率研究组高于对照组（P<0.05）；术后6个月嗓音学指标研究组低于对照组（P<0.05）；术后生活质量评分研究组略高于对照组，差异无统计学意义（P>0.05）；5年生存率、局部复发率研究组较对照组无统计学差异（P>0.05）。 结论 等离子射频消融术治疗老年早期声门型喉癌临床疗效较好，具有嗓音恢复快、术后疼痛感轻的优势，值得临床推广应用。

Long-term effect of radiofrequency ablation in the treatment of early glottic cancer in the elderly and its effect on voice acoustics

Objective　To investigate the long-term effect of radiofrequency ablation in the treatment of early glottic cancer (EGC) in the elderly and its effect on voice acoustics.　Methods　The clinical data of 95 patients with EGC admitted to our hospital from May 2010 to May 2011 were analyzed retrospectively. Patients were divided into two groups according to the different treatment methods. Control group (n=46) received the CO2 laser surgery, and study group (n=49) received the radiofrequency ablation. Then various indexes were compared between groups, including operation time, hospitalization time, VAS score, total effective rate, voice acoustics indexes Jitter, normalized noise energy (NNE), amplitude perturbation (Shimmer)], quality of life (bodily pain, physiological function, general health score), and long-term efficacy (5-year survival rate, local recurrence).　Results　There were no statistical difference in the VAS score between the study group and the control group (P>0.05), and the total effective rate of the study group was significantly higher than that of the control group (P<0.05). Jitter, NNE and Shimmer in the study group were lower than in the control group (P<0.05). The postoperative quality of life scores in the study group were slightly higher than those in the control group, with no statistic difference (P>0.05). There were no statistical difference in 5-year survival rate and local recurrence rate between the two groups(P>0.05).　Conclusions　The application of radiofrequency ablation in the treatment of EGC in the elderly has the advantages of fast voice recovery, which is worthy of clinical promotion.