可吸收胶原膜在累及前联合的声门型喉癌手术中的应用
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西安交通大学第二附属医院耳鼻咽喉头颈外科

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Application of absorbable collagen membrane in surgery of anterior combined glottic carcinoma
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1.Department of Otorhinolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xi'2.'3.an Jiaotong University,Xi'4.an,Shaanxi

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    [] 目的:探讨可吸收胶原膜一期置入在累及前联合的声门型喉癌内镜手术中的应用价值及治疗效果。方法:累及前联合的声门型喉癌患者19例,全麻支撑喉镜下行喉肿瘤切除术,同期放置修剪合适大小可吸收胶原膜并经环甲膜固定,1周后去除喉外固定缝线。所有患者随访6个月至5年不等,随访内容包括:声带创面恢复情况,前联合形态、发音功能指标。结果:1.术后随访时,除1例患者术后1月复查时发现肿瘤残余复发,3例患者声带前端粘连,其余15例患者均未出现呼吸困难且声带前联合获得良好三角形形态;2.术后疼痛评分中17例(89.5%)轻度疼痛,2例(10.5%)中度疼痛,均无重度疼痛;3.术后半年黏膜功能稳定后行嗓音功能评估,主观声学参数VHI手术前后(19.37±5.73 vs 60.63±12.93),差异有统计学意义(p<0.001);客观声学参数MPT手术前后(10.07±1.47vs14.40±1.48),差异有统计学意义(p<0.001); DSI手术前后(-1.52±4.20vs0.97±2.12),差异均具有统计学意义(p<0.001)。结论:一期置入可吸收胶原膜可预防累及前联合声门型喉癌切除术后双侧声带粘连,且患者术后疼痛感轻微,可促进患者术后喉功能的恢复,无不良反应发生。

    Abstract:

    [] Objective: To explore the application value and therapeutic effect of one-stage implantation of absorbable collagen membrane in the operation of anterior combined glottic carcinoma under support laryngoscope. Methods: 19 patients with anterior combined glottic carcinoma underwent laryngeal tumor resection under general anesthesia supported laryngoscope. At the same time, they placed and trimmed the appropriate size absorbable collagen membrane and fixed it with cricothyroid membrane. After 1 week, the external laryngeal fixation suture was removed. All patients were followed up for 6 months to 5 years. The content of the follow-up included: vocal cord wound recovery, anterior joint morphology, and pronunciation function indicators. Results: 1. During the postoperative follow-up, except for 1 patient who found residual tumor recurrence during the 1 month postoperative reexamination, 3 patients had vocal cord adhesions, and the remaining 15 patients had no dyspnea and the vocal cords had a good triangle shape before the joint; 2 In the postoperative pain score, 17 cases (89.5%) had mild pain, 2 cases (10.5%) had moderate pain, and none of them had severe pain. 3. Voice function assessment and subjective acoustic parameter VHI surgery were performed after the mucosal function was stable for half a year after the operation. Before and after (19.37±5.73 vs 60.63±12.93), the difference was statistically significant (p<0.001); the objective acoustic parameters before and after MPT surgery (10.07±1.47vs14.40±1.48), the difference was statistically significant (p<0.001); Before and after DSI surgery (-1.52±4.20vs0.97±2.12), the difference was statistically significant (p<0.001). Conclusion: The first-stage implantation of absorbable collagen membrane can prevent bilateral vocal cord adhesions after resection of early glottic laryngeal carcinoma, and the patients have mild postoperative pain, which can promote the recovery of postoperative laryngeal function without adverse reactions.

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  • 收稿日期:2022-05-15
  • 最后修改日期:2022-06-19
  • 录用日期:2022-06-22
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