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目的探讨CO2激光治疗喉癌前病变的疗效。方法选取喉癌前病变患者48例,其中喉白斑23例,喉乳头状瘤6例,角化症2例,慢性肥厚性喉炎17例。行显微支撑喉镜下CO2激光病变切除术,术后定期随访并行电子鼻咽喉镜检查。结果 48例患者均顺利完成手术,术中未发生严重并发症,术后发音功能恢复良好。随访1~3年,一次性治愈43例(89.6%);复发3例(6.3%),其中喉白斑2例、喉乳头状瘤1例,再次手术并随访1年未复发;恶变2例(4.2%),为不典型增生患者,术后复发再次手术时病理确诊为喉鳞状细胞癌,行激光声带切除术,术后随访3年未复发。结论显微支撑喉镜下CO2激光治疗喉癌前病变具有微创、安全、精准的特点,术后复发率低,长期效果良好。
Objective To investigate the efficacy of CO2 laser in the treatment of laryngeal precancerous lesions. Methods 48 cases of laryngeal precancerous lesions were selected, including 23 cases of laryngeal white spot, 6 cases of laryngeal papilloma, 2 cases of keratosis and 17 cases of chronic hypertrophic laryngitis. The line of microscopic support laryngoscope under the CO2 laser lesion resection, regular follow-up after electronic throat laryngoscopy. Results All the 48 patients completed the operation successfully. No serious complications occurred during operation, and the postoperative phonological function recovered well. Three cases (6.3%) were recurred, including 2 cases of laryngeal white spot and 1 case of laryngeal papilloma. One case was followed up for one year without recurrence. Malignant lesions were found in 2 cases (89.6%), 4.2%). In patients with atypical hyperplasia, laryngeal squamous cell carcinoma was diagnosed as laryngeal squamous cell carcinoma at the time of reoperation after operation, and laser vocal cord excision was performed. No recurrence was observed after 3 years of follow-up. Conclusions The laryngoscopic treatment of laryngoscopic CO2 laser with minimally invasive, safe and precise laryngocarcinoma has a low recurrence rate and good long-term results.