資源描述:
《兒童復發(fā)性喉乳頭狀瘤臨床治療探討》由會員上傳分享,免費在線閱讀,更多相關內容在學術論文-天天文庫。
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4~8次,16例患者治愈,術后隨訪3~
2、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?!娟P鍵詞】兒童喉乳頭狀瘤;鼻內鏡;激光;透明質酸鈉凝膠【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