山东大学耳鼻喉眼学报 ›› 2019, Vol. 33 ›› Issue (2): 81-85.doi: 10.6040/j.issn.1673-3770.0.2018.177

• 论著 • 上一篇    



  1. 1.南方医科大学南方医院耳鼻咽喉头颈外科, 广东 广州 510515;
    2.中国人民解放军南部战区总医院耳鼻咽喉头颈外科, 广东 广州 510010
  • 发布日期:2019-03-28
  • 作者简介:徐夏. E-mail:cnxuxia@qq.com
  • 基金资助:

Curative effect analysis of endoscopic laryngeal surgery with plasma radiofrequency ablation versus open surgery to treat early glottic cancer

XU Xia1,2, DENG Wenting2, HUANG Chengzhi2, CHEN Yongting2, WANG Jian2   

  1. Department of Otolaryngology, General Hospital of Southern Theatre Command of PLA, Guangzhou 510010, Guangdong, China
  • Published:2019-03-28

摘要: 目的 探讨经支撑喉镜内镜辅助下等离子消融术治疗早期声门型喉癌的疗效,并与常规开放性手术作对比分析。 方法 回顾早期声门型喉鳞癌55例患者临床资料,按手术方式分为等离子组35例、喉裂开组20例,分析比较两组手术情况、并发症、复发率,并应用嗓音分析软件比较两组患者术后嗓音恢复情况。 结果 等离子组及喉裂开组患者在手术时间[(15.60±7.20)vs(94.00±9.95)min)]、术中出血[(8.94±8.06)vs(100.75±28.34)mL]、住院时间[(6.86±0.77)vs(11.45±1.05)d]、术后疼痛视觉模拟评分[(2.66±0.91)vs(4.65±1.04)分]及呛咳评分[(3.60±0.85)vs(6.05±1.23)分]的差异均有统计学意义(P<0.05);两组术后肉芽增生发生率及复发率差异无统计学意义(P>0.05);术后12个月嗓音分析两组嗓音参数(Jitter、Shimmer、HNR)均较术前好转,等离子组上述参数恢复情况均优于喉裂开组:基频微扰(Jitter)[(0.66±0.15)vs(0.78±0.18)%],振幅微扰(Shimmer)[(4.57±1.14)vs(5.66±0.97)%],谐噪比(HNR)[(17.41±2.58 )vs(15.39±1.63)dB],组间差异有统计学意义(P<0.05)。 结论 经支撑喉镜内镜辅助下等离子消融术治疗早期喉癌疗效确切,较喉裂开术具有微创、高效、术后嗓音恢复好的优势。

关键词: 早期声门型喉癌, 等离子消融术, 喉裂开术, 嗓音分析

Abstract: Objective To evaluate the clinical efficacy of endoscopic laryngeal surgery with plasma radiofrequency ablation vs. conventional open surgery to treat early glottic cancer. Methods Resection of laryngeal cancer was performed at our hospital between January 2013 and August 2016 in 55 patients with early glottic squamous cell cancer. Endoscopic laryngeal surgery with plasma radiofrequency ablation was performed in 35 patients(plasma group), and open surgery was performed in 20 patients(laryngofissure group). The situation of surgery, complications, recurrence rate, and postoperative change in voice were compared between the groups. Results The intraoperative blood loss(8.94±8.06 vs. 100.75±28.34 mL), operative time(15.60±7.20 vs. 94.00±9.95 min), length of hospitalization(6.86±0.77 vs. 11.45±1.05 days), postoperative pain scores(2.66±0.91 vs. 4.65±1.04), and the cough visual analogue scale scores(3.60±0.85 vs. 6.05±1.23)in the plasma group were better than those in the laryngofissure group(P<0.05). However, no intergroup difference was observed in the granulation hyperplasia and recurrence rates(P>0.05). Acoustic parameters, including fundamental frequency perturbation(jitter)(0.78±0.18 vs. 0.66±0.15%), amplitude perturbation(shimmer)(5.66±0.97 vs. 4.57±1.14%), and the harmonic noise ratio(17.41±2.58 vs. 15.39±1.63 dB)recorded a year postoperatively showed more significant improvement in the plasma than in the laryngofissure group. Notably, this intergroup difference was statistically significant(P<0.05). Conclusion Endoscopic laryngeal surgery with plasma radiofrequency ablation effectively treats early glottic cancer. This procedure scores over open surgery in terms of being a minimally invasive and highly effective approach associated with better voice preservation.

Key words: Early glottic cancer, Plasma radiofrequency ablation, Laryngofissure, Voice analysis


  • R767.91
[1] Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018[J]. Ca A Cancer Journal for Clinicians, 2018, 60(5):277-300.
[2] Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2):115-132.
[3] 周天骄, 易红良. 等离子射频消融技术治疗早期声门型喉癌的研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2015(6):577-580. ZHOU Tianjiao, YI Hongliang. The progress of radiofrequency ablation technique in the early glottic cancer[J]. Clin J Otorhinolarynol Head Neck Surg, 2015(6):577-580.
[4] Edge SB, Compton CC. The american joint committee on cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM[J]. Annals of Surgical Oncology, 2010, 17(6):1471-1474.
[5] Tibbetts KM, Tan M. Role of advanced laryngeal imaging in glottic cancer: early detection and evaluation of glottic neoplasms[J]. Otolaryngol Clin North Am, 2015, 48(4): 32-52.
[6] Adelstein D, Gillison ML, Pfister DG, et al. NCCN Guidelines Insights: Head and Neck Cancers, Version 2.2017[J]. J Natl Compr Canc Netw, 2017, 15(6):761-770.
[7] Takes RP, Strojan P, Silver CE, et al. Current trends in initial management of hypopharyngeal cancer: the declining use of open surgery[J]. Head Neck. 2012 Feb; 34(2):270-281.
[8] Khan M K, Koyfman S A, Hunter G K, et al. Definitive radiotherapy for early(T1-T2)Glottic Squamous cell carcinoma: a 20 year Cleveland clinic experience[J]. Radiation Oncology, 2012, 7(1):193-193.
[9] Megwalu UC, Panossian H.Survival Outcomes in Early Stage Laryngeal Cancer[J]. Anticancer Res, 2016, 36(6):2903-2907.
[10] Mahler V, Boysen M, Brøndbo K. Radiotherapy or CO2 laser surgery as treatment of T1a glottic carcinoma?[J]. Eur Arch Otorhinolaryngol, 2010, 267(5):743-750.
[11] Lee HS, Chun BG, Kim SW, et al.Transoral laser microsurgery for early glottic cancer as one-stage single-modality therapy[J]. Laryngoscope, 2013, 123(11):2670-2674.
[12] 王琦, 范国康. T1声门型喉癌的治疗选择[J]. 临床耳鼻咽喉头颈外科杂志, 2016(2):166-172. WANG Qi, FANG Guokang. Treatment options of T1 glottic carcinoma [J]. Clin J Otorhinolarynol Head Neck Surg, 2016(2):166-172.
[13] 中华耳鼻咽喉头颈外科杂志编辑委员会头颈外科组,中华医学会耳鼻咽喉头颈外科学分会头颈学组,李晓明等.喉癌外科手术及综合治疗专家共识[J].中华耳鼻咽喉头颈外科杂志,2014,49(8):620-626.
[14] Scarlata S, Fuso L, Lucantoni G, et al. The technique of endoscopic airway tumor treatment[J]. J Thorac Dis, 2017, 9(8):2619-2639.
[15] 张庆丰, 刘得龙, 张悦,等. 等离子射频治疗早期声门型喉癌的初步研究[J]. 中华耳鼻咽喉头颈外科杂志, 2011, 46(1):63-65. ZHANG Qingfeng, LIU Delong, ZHANG Yue, et al. Preliminary investigation of coblation for early glottic carcinoma[J]. Chin J Otorhinolarynol Head Neck Surg, 2011, 46(1):63-65.
[16] Liu B, Cheng L, Ming H, Zhong C. Treatment of the early-stage glottic cancer using low-temperature radiofrequency coblation[J]. J Cancer Res Ther, 2016, 12(2):830-833.
[17] Çukurova(·overI)1, Gümü soy M, Çetinkaya EA, et al. A comparison of histopathological results of conventional surgery and transoral radiofrequency ablation in early stage laryngeal carcinoma[J]. Kulak Burun Bogaz Ihtis Derg, 2013, 23(6):325-305.
[18] 卢大松, 冯勇军, 曾春荣,等. 内镜下低温等离子射频消融术与常规喉裂开术治疗早期声门型喉癌疗效的对比分析[J]. 临床与病理杂志, 2016, 36(12):1975-1980. LU Dasong, FENG Yongjun, ZENG Chunrong, et al. Curative effect analysis of endoscopy low-temperature plasma radiofrequency ablation and normal laryngeal crack treatment in early glottis type of throat cancer[J]. Int J Pathology Clinical Med, 2016, 36(12):1975-1980.
[1] 仇书要,刘大波,钟建文,杨李强. 儿童阻塞性睡眠呼吸暂停低通气综合征等离子[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 34-37.
[2] 徐文雅,刘婷婷,姜晓丹,党志红,娄帅帅,张念凯. 低温等离子消融术与下鼻甲成形术治疗慢性鼻炎的对比研究[J]. 山东大学耳鼻喉眼学报, 2014, 28(1): 27-30.
Full text



No Suggested Reading articles found!