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投稿时间：2025-04-28 网络发布日期：2025-12-25
投稿时间：2025-04-28 网络发布日期：2025-12-25
中文摘要: 目的 比较硬性喉镜下CO2激光联合低温等离子射频消融术与单纯CO2激光治疗早期声门型喉癌疗效及围手术期情况的差异。方法 回顾性纳入2020年6月至2023年6月于南京大学医学院附属鼓楼医院诊治的97例早期声门型喉癌患者，其中行CO2激光联合低温等离子手术治疗的42例患者纳入试验组，单纯行CO2激光治疗的55例患者纳入对照组。记录并比较患者围手术期情况、术后不良反应及术后1年复发率。结果 试验组手术时长低于对照组［44.79（28.75，60.00）min vs 60.33（40.00，65.00）min，Z=2.537，P=0.011］。术后1年对照组肿瘤复发6例，试验组未见复发，但两组复发率比较差异无统计学意义（P>0.05）。与对照组相比，试验组术中出血量低且住院时长较短，但差异无统计学意义（P>0.05）。试验组术中出现26例咽弓撕裂及6例牙齿损伤，对照组出现了45例咽弓撕裂及18例牙齿损伤，差异均有统计学意义（P<0.05）。试验组和对照组术后皮下气肿发生率差异有统计学意义［11.90%（5/42）vs29.09%（16/55），χ2=4.147，P=0.042］。结论 CO2激光联合低温等离子治疗早期声门型喉癌可缩短手术时长，减少术中出血量，减少术后不良反应的发生，降低术后复发率，更安全有效。
Abstract:Objective To compare the differences of efficacy and perioperative conditions between CO2 laser combined with low-temperature plasma radiofrequency ablation and CO2 laser alone in treating early-stage glottic carcinoma, with a rigid laryngoscope. Methods A total of 97 patients with early-stage glottic carcinoma treated at Nanjing Drum Tower Hospital from June 2020 to June 2023 were included. Among them, 42 patients who underwent CO2 laser combined with low-temperature plasma were included in the experimental group, while 55 patients who received only CO2 laser treatment were included in the control group. Perioperative conditions, postoperative adverse reactions, and one-year recurrence rates after surgery were recorded and compared. Results The operative duration in the experimental group was shorter than that in the control group [44.79 (28.75, 60.00) min vs 60.33 (40.00, 65.00) min, Z= 2.537, P=0.011]. At 1 year postoperatively, tumor recurrence occurred in 6 cases in the control group, while no recurrence was observed in the experimental group; however, the difference in recurrence rates between the two groups was not statistically significant (P>0.05). Compared with the control group, the experimental group had lower intraoperative blood loss and a shorter hospital stay, but these differences were not statistically significant (P>0.05). In the experimental group, 26 cases of palatopharyngeal arch tear and 6 cases of dental injury occurred during surgery, while in the control group, 45 cases of palatopharyngeal arch tear and 18 cases of dental injury occurred, with both differences being statistically significant (P<0.05). The incidence of postoperative subcutaneous emphysema differed significantly between the experimental group and control group [11.90 (5/42) vs 29.09% (16/55), χ2=4.147, P=0.042]. Conclusion CO2 laser combined with low-temperature plasma for early-stage glottic carcinoma can reduce the operation time, intraoperative blood loss, the incidence of postoperative adverse reactions, and the recurrence rate, making it safer and more effective.
keywords: Laryngeal malignancy Glottic type Low-temperature plasma radiofrequency ablation CO2 laser Rigid laryngoscopy
文章编号： 中图分类号：R739.65 文献标志码：A
基金项目:江苏省医学重点学科/实验室（ZDXK202243）
附件
引用文本：
董琦,邢宇轩,梁正,等.硬性喉镜下CO2 激光联合低温等离子治疗早期声门型喉癌[J].中国临床研究,2025,38(12):1878-1881.
董琦,邢宇轩,梁正,等.硬性喉镜下CO2 激光联合低温等离子治疗早期声门型喉癌[J].中国临床研究,2025,38(12):1878-1881.