微型内镜在喉、气管、支气管疾病微创治疗中的应用

目的探讨微型内镜手术治疗喉、气管、支气管疾病的临床应用价值。方法在微型内镜下进行喉部手术及气管、支气管异物取出术166例。其中声带小结19例，声带息肉75例，声带乳头状瘤16例，声带囊肿6例，会厌囊肿9例，喉部血管瘤5例，喉部淀粉样瘤19例，声带角化症3例，声带白斑2例，声带癌6例，气管、支气管异物6例。结果气管、支气管异物6例取出成功。另160例中除3例喉部血管瘤术中出血较多，使用微波处理止血外，余157例手术经过顺利。手术时间30-60min，平均45min。喉部手术经过顺利，无术后并发症。随访2—12个月，平均6个月，发音恢复正常148例．好转12例。6例声带癌术后随访1年无复发。结论微型内镜应用在喉、气管、支气管疾病中具有手术视野广、直接、清晰、照明度高等优点，使手术在微创的前提下彻底清除病灶并最大限度保留功能。

Application of microendoscope in minimally invasive treatment of laryngeal, tracheal, and bronchial diseases

Objective To investigate the clinical application value of microendoscope in the treatment of laryngeal,tracheal,and bronchial diseases.Methods Under microendoscope,laryngological operations or tracheal or bronchial foreign body removal were carried out in 166 cases,including 19 cases of vocal nodule,75 cases of polyp of the vocal cord,16 cases of papilloma of the vocal cord,6 cases of cyst of the vocal cord,9 cases of cyst of the epiglottis,5 cases of laryngeal hemangioma,19 cases of laryngeal amyloidosis,3 cases of keratosis of the vocal cord,2 cases of leukoplakia of the vocal cord,6 cases of glottic cancer,and 6 cases of tracheal or bronchial foreign body.Results Foreign bodies in the trachea or the bronchus were removed successfully in all the 6 cases.Of the rest of 160 cases,laryngological operations were accomplished smoothly in 157 cases while a relatively large amount of hemorrhage was encountered in 3 cases and treated with microwave hemostasis.The operation time was 30~60 min(mean,45 min).No postoperative complications occurred.Follow-up observations for 2~12 months(mean,6 months) showed 148 cases of full recovery of vocal function and 12 cases of improvement.No recurrence was found in the 6 cases of glottic cancer during 1 year of(follow-up).Conclusions The application of microendoscope in the treatment of laryngeal,tracheal,and bronchial diseases has advantages of broad surgical view and direct and clear visualization.This minimally invasive procedure can remove the lesion thoroughly and reserve functions to the greatest advantages.