视频喉镜下声门旁间隙脂肪注射治疗单侧声带麻痹疗效观察.docVIP

视频喉镜下声门旁间隙脂肪注射治疗单侧声带麻痹疗效观察 　　【摘要】 目的：通过对抽脂术、块状脂肪切取和脂肪颗粒切取三种不同自体脂肪获取方法下视频喉镜下声门旁间隙脂肪注射治疗单侧声带麻痹的远近期疗效观察，初步探讨最佳的脂肪获取方法。方法：选取单侧声带麻痹患者45例，根据脂肪获取方法的不同将所有患者分为A、B、C组，每组各15例，A组经抽脂术获取脂肪，B组经块状脂肪切取获取脂肪，C组以脂肪颗粒切取获取脂肪，观察各组患者手术前后患侧声带及健侧声带上表面面积变化、各组患者术前后术后各时间嗓音分析。结果：所有患者患侧声带内注射脂肪后体积显著增加，患者患侧声带大小术后即刻显著高于术前（P0.05）；术后1、3、6、12个月患侧声带大小逐渐缩小，均较术前显著增加（P0.05）；且C组患者术后3、6、12个月显著小于A、B组（P0.05）。各组术后各时间段最大发音时间、Jitter、Shimmer及NNE较术前均有明显改善（P0.05），但术后1个月最大发音时间较其他时间段改善显著，术后3、6、12个月改善情况均逐渐降低；C组改善情况略好于A、B组。结论：采用脂肪颗粒切取获取脂肪注射治疗单侧声带麻痹效果良好，应用前景广阔。 　　【关键词】 视频喉镜； 声门旁间隙脂肪注射； 单侧声带麻痹； 疗效 　　【Abstract】 Objective：To liposuction， massive fat cut and fat particles cut from three different methods to obtain autologous fat video laryngoscope subglottic space fat injection for unilateral vocal cord paralysis and long term efficacy of observation，explore the best method to get fat.Method：45 cases with unilateral vocal cord paralysis，according to the different fat acquisition method all patients were divided into A，B，and C group，15 cases in each group.A group was given liposuction，B group with massive fat cut，C group was given fat particles.The surface area of the vocal voice on patients postoperative side and contralateral vocal with patients before and after operation in each group were compared.Result：All patients with ipsilateral vocal cord injection after fat volume increased significantly，the immediate postoperative patients with vocal cord size was significantly higher than that before operation（P0.05）；after surgery 1，3，6，and 12 months，ipsilateral vocal cord size were gradually reduced compared with the preoperative significantly increased（P0.05）；the patients in C group after operation 3，6，and 12 months were significantly lower than that of A and B group（P0.05）.After surgery，the maximum phonation time，Jitter，Shimmer and NNE in three groups were significantly improved compared with preoperative（P0.05），but the sound of 1 month after surgery was significantly improved than other period，after surgery 3，6，and 12 mon