儿童复发性喉乳头状瘤临床治疗探讨_临床医学论文.docVIP

儿童复发性喉乳头状瘤临床治疗探讨_临床医学论文 儿童复发性喉乳头状瘤临床治疗探讨_临床医学论文 【摘要】 目的 探讨和评价鼻内镜下微电动吸切协同激光治疗儿童喉乳头状瘤的可行性和手术疗效。方法 回顾性分析近5年期间26例儿童复发性喉乳头状瘤患者的临床资料，对上述患者分别采取了鼻内镜下单纯行电动吸切术6例，鼻内镜下微电动吸切术协同激光治疗，并结合对术腔创面涂透明质酸钠凝胶20例，对两种手术方式的疗效进行了分析评价。结果 对单在鼻内镜下行微电动吸切术切除喉复发性乳头状瘤的患者，术后4周纤维喉镜检发现喉乳头状瘤复发，术后2～3个月需再次手术；鼻内镜微电动吸切后协同激光治疗的患者，术后2～3周内，喉部创面再次辅助激光治疗4～8次，16例患者治愈，术后随访3～8年无复发，4例患者复发间隔延长。结论 鼻内镜下电动吸切术协同激光治疗能有效降低喉乳头状瘤的复发，该术式要求术后短期内反复多次激光辅助治疗，并且对术腔创面采用了透明质酸钠凝胶，从而避免了声带瘢痕过大和粘连，大大提高了患者的发音质量，部分患者通过该手术方案的治疗能达到完全治愈的目的，因此该治疗方式值得提倡与推广。 【关键词】 儿童喉乳头状瘤；鼻内镜；激光；透明质酸钠凝胶 【Abstract】 Objective To study and evaluate the feasibility and effect of nasal endoscopy electric suction cutting and laser surgery for recurrent laryngeal papilloma in juvenile. Methods The clinical data of 26 cases of recurrent laryngeal papilloma from 2002 to 2007 were retrospectively analyzed. 12 cases of male and 14 cases of female, their average age was 6.4 years (1 to 14 years). The patients were treated by electric suction cutting under nasal endoscopy or electric suction cutting synergying laser, and postoperative wound with sodium hyaluronate gel treatment. Results The recurrent laryngeal papilloma were only operated by electric suction cutting with nasal endoscopy, laryngeal papilloma relapsed with fibrolaryngoscope examination after operation four weeks, and were operated again during 2 to 3 months. The recurrent laryngeal papilloma were treated by electric suction cutting synergies laser treatment with the help of nasal endoscopy and they were also treated repeatedly several times with laser after 2 or 3 weeks. 16 cases cured perfectly with no reappearance after 3 to 8 years, and the other 4 cases were recurrence interval prolongation.Conclusion Electric suction synergy laser treatment can effectively reduce the recurrence and also need laser treatment several times after operation to improve the cure effect. The sodium hyaluronate gel is adopted on the wound of vocal cords, it is avoid the vocal cords scar and adhesion, and to improve the quality