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目的探讨显微支撑喉镜下CO_2激光治疗声门型喉癌的远期治疗效果。方法对声门型喉癌患者106例,采用显微支撑喉镜下CO_2激光治疗,回顾性分析病历资料。其中T_(is)N_0M_04例、T_(1a)N_0M_062例、T_(1b)N_0M_016例、T_2N_0M_022例、T_3N_0M_02例。结果 106例患者手术顺利,无严重并发症发生。术后死于复发或颈部转移4例,死于意外4例,死于远处转移2例,失访4例,术后局部复发者再次手术后至今良好2例。目前92例仍存活,无肿瘤复发,生活质量良好。3年、5年和10年生存率分别为98.7%、95.2%和89.0%,总局部复发率为5.7%。结论显微支撑喉镜下CO_2激光手术是治疗T_(is)、T_(1a)声门型喉癌的首选方法,手术创伤小,术后恢复快,喉功能保全好,远期生存率高;该手术对于经过精心选择的声门型T_(1b)和T_2、T_3喉癌也有较好的临床疗效。
Objective To investigate the long-term therapeutic effect of CO_2 laser in the treatment of glottic laryngeal carcinoma under microscopic support laryngoscope. Methods 106 patients with glottic cancer were treated with CO_2 laser under the support of the laryngoscope. The medical records were retrospectively analyzed. T_ (is) N_0M_04 cases, T_ (1a) N_0M_062 cases, T_ (1b) N_0M_016 cases, T_2N_0M_022 cases and T_3N_0M_02 cases. Results 106 patients were successfully operated without serious complications. 4 patients died of recurrence or neck metastasis, 4 patients died of accident, 2 patients died of distant metastasis and 4 patients were lost to follow-up. The local recurrence after operation was good in 2 cases since the second operation. At present 92 cases are still alive, no tumor recurrence, good quality of life. The 3-year, 5-year and 10-year survival rates were 98.7%, 95.2% and 89.0%, respectively. The total local recurrence rate was 5.7%. Conclusions CO_2 laser under microscopic support laryngoscopy is the first choice for the treatment of T_ (1a) glottic laryngeal carcinoma. The trauma is small, the postoperative recovery is quick, the preservation of laryngeal function is good, and the long - term survival rate is high. The surgery for well-selected glottic T_ (1b) and T_2, T_3 laryngeal cancer have better clinical efficacy.