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目的 :探讨磷酸钛钾 (KTP)激光声带切除术治疗早期声门癌的效果。方法 :对 30例行激光声带切除术者 (激光组 )和 18例行喉裂开声带切除者 (喉裂开组 )术后的喉内结构变化、音质、生存质量等进行对比分析。结果 :激光组半年后在原声带处长出一新声带 ,音质明显提高接近正常 ,生存质量较高。喉裂开组无新声带形成 ,音质半年内较好而后持续较差 ;生存质量在拔管前较低 ,拔管后同激光组。术后观察 2～ 4年 ,激光组 2例复发 ,喉裂开组 1例复发 ,两组均无淋巴转移 ,无一例死于喉癌。结论 :KTP激光治疗早期声门癌在确保根治的基础上 ,术后喉功能结构恢复良好 ,损伤小 ,患者生存质量高 ,实现了喉癌的微创治疗 ,明显优于喉裂开声带切除术。
Objective: To investigate the effect of KTP laser vocal cord excision on early stage of glottic cancer. Methods: The changes of throat structure, sound quality and quality of life in 30 patients who underwent laser vocal cord excision (laser group) and 18 patients who underwent laryngectomy open vocal cord excision (laryngectomy group) were compared and analyzed. Results: The laser group grew a new vocal cords in the original vocal cords after six months, the sound quality improved obviously close to normal and the quality of life was higher. There was no new vocal cords in the laryngeal rupture group, the sound quality was better in the first half of the year and then continued to be worse; the quality of life was lower before extubation, and the same laser group after extubation. Two to four years after operation, two patients relapsed in the laser group and one patient developed laryngeal rupture. There was no lymphatic metastasis in both groups, and none died of laryngeal cancer. Conclusion: KTP laser treatment of early stage of glottic cancer, based on the radical cure, possesses good recovery of the functional structure of the larynx, small injury and high quality of life. It achieves minimally invasive treatment of laryngeal carcinoma, which is obviously superior to laryngeal rupture open vocal cord excision .