支撑喉内窥镜下激光治疗早期声带癌和癌前病变

摘要

目的:探讨支撑喉内窥镜下激光治疗早期声带癌和癌前病变的方法、临床疗效及适应症.方法:支撑喉内窥镜下Nd:YAP激光治疗的早期声带癌(T1N0M0)13例(T1a型9例,T1b型4例),癌前病变24例,全部病例通过电话及门诊复诊定期随访.结果:所有病例未出现手术并发症.3例癌前病变患者失访;2例声带癌侵及前联合患者分别于术后3月和1 年复发;2例喉乳头状瘤于术后1年复发.结论:与喉裂开术相比,支撑喉内窥镜下激光治疗早期声带癌和癌前病变具有手术创伤小、安全、吞咽功能恢复快、住院时间短等优点.但侵及前联合的早期喉癌有较高的复发率.%Objective:To explore the technique,therapeutic effectiveness and indication of the early vocal cords cancer and precancerous of larynx treated with Nd:YAP laser under the laryngoscope and rigid endoscope. Methods:Thirteen patients with early glottic cancer(9 cases in T1a stage,4 in T1b) and 24 cases of precancerosis of larynx were treated with Nd:YAP laser under the laryngeal rigid endoscope. All patients were regularly followed up by phone or reture visit examination for 1-4 years. Results: Complications were not found in any patient,3 cases of precancerosis were lost of follow-up,2 cases of vocal cancer invading to anterior commissure relapsed at 3 month and 1 year after the operation,2 cases of laryngeal papilloma relapsed 1 year later. Conclusion: Compared with the laryngofissure,early vocal cords cancer and precancerosis of larynx treated with Nd:YAP laser under the laryngoscope and rigid endoscope is mini-invasive for patient,safe,fast recovery of swallow,short time of hospitalization.However the relapse rate is higher for the vocal cancer invading to anterior commissure.