两种不同方式的声带息肉手术比较

目的比较全麻显微支撑喉镜和表麻电子喉镜下声带息肉摘除优缺点及术后的疗效.方法选取我院门诊声带息肉患者72例,随机分为两组,一组行支撑喉镜手术,另一组行电子喉镜手术,每组36例,每例患者均在术前及术后1月行电子喉镜检查及嗓音声学测试.结果支撑喉镜手术组一次性完成手术33例,改用电子喉镜下手术2例,需电子喉镜补充手术1例,电子喉镜手术组一次性完成手术35例,需2次完成手术1例.两组术后嗓音声学参数均明显优于手术前,统计学上差异有显著性意义(P＜0.05).结论电子喉镜下声带息肉摘除是微创手术,具有视野清晰、操作准确、创伤小、痛苦小、门诊手术、费用少等优点,能完成支撑喉镜下无法完成的手术,术后疗效和支撑喉镜下手术相仿.

A comparison of therapeutic effects between the surgical procedures with self-retaining laryngoscope and electronic laryngoscope on vocal polyp

Objective To compare the therapeutic effects of surgical procedures with self-retaining laryngoscope(SRL)and electronic laryngoscope(EL)on vocal polyp. Methods 72 patients with vocal polyp were included in this study. They were randomly divided into 2 groups, with 36 cases in group 1 treated with SRL under general anesthesia and another 36 cases in group 2 treated with EL under superficial mucosal anesthesia. Electronic laryngoscopy was given to all the patients and their voice and acoustic parameters were tested before the surgery and one month after the operation. Results In the group of cases with SRL, 33 were successfully operated on only by once operation. Among the other 3 failed cases with the procedure in this group,one was successfully operated on with the supplementation of EL and two were only successful in their surgery under EL. In contrast, 35 patients were successfully operated on once in the group of cases with EL,only one case operated on twice in this way with success. All the cases in the two groups showed significantly improved acoustic parameters following the operation (P<0. 01) while there were no significant differences found between the two groups (P < 0. 05) . Conclusions The operation under electronic laryngoscope is a minimal invasive procedure to the laryngeal mucosa, with such more advantages like clear view of operation field, accurate management to the lesion tissue and little painful feeling during the operation. Furthermore,it can be used for those patients with lesions impossibly operated on by self-retaining laryngoscope, with similar therapeutic effects as that under self-retaining laryngoscope.