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1、兒童復發(fā)性喉乳頭狀瘤臨床治療探討【摘要】目的探討和評價鼻內鏡下微電動吸切協(xié)同激光治療兒童喉乳頭狀瘤的可行性和手術療效。方法回顧性分析近5年期間26例兒童復發(fā)性喉乳頭狀瘤患者的臨床資料，對上述患者分別采取了鼻內鏡下單純行電動吸切術6例，鼻內鏡下微電動吸切術協(xié)同激光治療，并結合對術腔創(chuàng)面涂透明質酸鈉凝膠20例，對兩種手術方式的療效進行了分析評價。結果對單在鼻內鏡下行微電動吸切術切除喉復發(fā)性乳頭狀瘤的患者，術后4周纖維喉鏡檢發(fā)現(xiàn)喉乳頭狀瘤復發(fā)，術后2～3個月需再次手術；鼻內鏡微電動吸切后協(xié)同激光治療的患者，術后2～3周內，喉部創(chuàng)面再次輔助激光治療4
2、～8次，16例患者治愈，術后隨訪3～8年無復發(fā)，4例患者復發(fā)間隔延長。結論鼻內鏡下電動吸切術協(xié)同激光治療能有效降低喉乳頭狀瘤的復發(fā)，該術式要求術后短期內反復多次激光輔助治療，并且對術腔創(chuàng)面采用了透明質酸鈉凝膠，從而避免了聲帶瘢痕過大和粘連，大大提高了患者的發(fā)音質量，部分患者通過該手術方案的治療能達到完全治愈的目的，因此該治療方式值得提倡與推廣。【關鍵詞】兒童喉乳頭狀瘤；鼻內鏡；激光；透明質酸鈉凝膠【Abstract】ObjectiveTostudyandevaluatethefeasibilityandeffectofnasalendosco
3、pyelectricsuctioncuttingandlasersurgeryforrecurrentlaryngealpapillomainjuvenile.MethodsTheclinicaldataof26casesofrecurrentlaryngealpapillomafrom2002to2007wereretrospectivelyanalyzed.12casesofmaleand14casesoffemale,theiraverageagewas6.4years(1to14years).Thepatientsweretreate
4、dbyelectricsuctioncuttingundernasalendoscopyorelectricsuctioncuttingsynergyinglaser,andpostoperativewoundwithsodiumhyaluronategeltreatment.ResultsTherecurrentlaryngealpapillomawereonlyoperatedbyelectricsuctioncuttingwithnasalendoscopy,laryngealpapillomarelapsedwithfibrolary
5、ngoscopeexaminationafteroperationfourweeks,andwereoperatedagainduring2to3months.Therecurrentlaryngealpapillomaweretreatedbyelectricsuctioncuttingsynergieslasertreatmentwiththehelpofnasalendoscopyandtheywerealsotreatedrepeatedlyseveraltimeswithlaserafter2or3weeks.16casescure
6、dperfectlywithnoreappearanceafter3to8years,andtheother4caseswererecurrenceintervalprolongation.ConclusionElectricsuctionsynergylasertreatmentcaneffectivelyreducetherecurrenceandalsoneedlasertreatmentseveraltimesafteroperationtoimprovethecureeffect.Thesodiumhyaluronategelisa
7、doptedonthewoundofvocalcords,itisavoidthevocalcordsscarandadhesion,andtoimprovethequalityofpronunciation.Somepatientscanbecuredbythistreatmentmethod,anditisshouldbeadvocatedintheclinicalwork.5【Keywords】Laryngealpapillomainjuvenile;nasalendoscopy;laser;sodiumhyaluronategel在過
8、去的30余年里，喉顯微手術加CO2激光是兒童喉乳頭狀瘤的首選。隨著科技發(fā)展，可應用于喉部手術的器械也越來越多，近年來被廣泛應用于喉乳頭狀瘤手術的顯微電動吸切器有取代
