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1、兒童復(fù)發(fā)性喉乳頭狀瘤臨床治療探討【摘要】目的探討和評(píng)價(jià)鼻內(nèi)鏡下微電動(dòng)吸切協(xié)同激光治療兒童喉乳頭狀瘤的可行性和手術(shù)療效。方法回顧性分析近5年期間26例兒童復(fù)發(fā)性喉乳頭狀瘤患者的臨床資料，對(duì)上述患者分別采取了鼻內(nèi)鏡下單純行電動(dòng)吸切術(shù)6例，鼻內(nèi)鏡下微電動(dòng)吸切術(shù)協(xié)同激光治療，并結(jié)合對(duì)術(shù)腔創(chuàng)面涂透明質(zhì)酸鈉凝膠20例，對(duì)兩種手術(shù)方式的療效進(jìn)行了分析評(píng)價(jià)。結(jié)果對(duì)單在鼻內(nèi)鏡下行微電動(dòng)吸切術(shù)切除喉復(fù)發(fā)性乳頭狀瘤的患者，術(shù)后4周纖維喉鏡檢發(fā)現(xiàn)喉乳頭狀瘤復(fù)發(fā)，術(shù)后2～3個(gè)月需再次手術(shù)；鼻內(nèi)鏡微電動(dòng)吸切后協(xié)同激光治療的患者，術(shù)后2～3周內(nèi)，喉部創(chuàng)面再次輔助激光治療4～8次，16例患者治愈，術(shù)后隨訪3～
2、8年無復(fù)發(fā)，4例患者復(fù)發(fā)間隔延長。結(jié)論鼻內(nèi)鏡下電動(dòng)吸切術(shù)協(xié)同激光治療能有效降低喉乳頭狀瘤的復(fù)發(fā)，該術(shù)式要求術(shù)后短期內(nèi)反復(fù)多次激光輔助治療，并且對(duì)術(shù)腔創(chuàng)面采用了透明質(zhì)酸鈉凝膠，從而避免了聲帶瘢痕過大和粘連，大大提高了患者的發(fā)音質(zhì)量，部分患者通過該手術(shù)方案的治療能達(dá)到完全治愈的目的，因此該治療方式值得提倡與推廣。【關(guān)鍵詞】兒童喉乳頭狀瘤；鼻內(nèi)鏡；激光；透明質(zhì)酸鈉凝膠【Abstract】ObjectiveTostudyandevaluatethefeasibilityandeffectofnasalendoscopyelectricsuctioncuttingandlasersurg
3、eryforrecurrentlaryngealpapillomain10juvenile.MethodsTheclinicaldataof26casesofrecurrentlaryngealpapillomafrom2002to2007wereretrospectivelyanalyzed.12casesofmaleand14casesoffemale,theiraverageagewas6.4years(1to14years).Thepatientsweretreatedbyelectricsuctioncuttingundernasalendoscopyorelectr
4、icsuctioncuttingsynergyinglaser,andpostoperativewoundwithsodiumhyaluronategeltreatment.ResultsTherecurrentlaryngealpapillomawereonlyoperatedbyelectricsuctioncuttingwithnasalendoscopy,laryngealpapillomarelapsedwithfibrolaryngoscopeexaminationafteroperationfourweeks,andwereoperatedagainduring2
5、to3months.Therecurrentlaryngealpapillomaweretreatedbyelectricsuctioncuttingsynergieslasertreatmentwiththehelpofnasalendoscopyandtheywerealsotreatedrepeatedlyseveraltimeswithlaserafter2or3weeks.16casescuredperfectlywithnoreappearanceafter3to8years,andtheother4caseswererecurrenceintervalprolon
6、gation.ConclusionElectricsuctionsynergylasertreatmentcaneffectivelyreducetherecurrenceandalsoneedlasertreatmentseveraltimesafteroperationtoimprovethecureeffect.Thesodiumhyaluronategelisadoptedonthewoundofvocalcords,itisavoidthevocalcordsscarandadhesion,andtoimprovethequalityofpronunciation.S
7、omepatientscan10becuredbythistreatmentmethod,anditisshouldbeadvocatedintheclinicalwork.【Keywords】Laryngealpapillomainjuvenile;nasalendoscopy;laser;sodiumhyaluronategel在過去的30余年里，喉顯微手術(shù)加CO2激光是兒童喉乳頭狀瘤的首選。隨著科技發(fā)展，可應(yīng)用于喉部手術(shù)的器械也越來越多，近年來被廣泛應(yīng)用于喉乳頭狀瘤手術(shù)的顯微電動(dòng)吸切器
