张小伯 刘丹丹 杨大章 范为 100029 北京 中日友好医院耳鼻咽喉科 中华耳鼻咽喉科杂志 1999 0 34 6


    关键词：喉肿瘤；；喉切除术；；综合疗法；；粘膜剥脱 期刊 zhebyhzz 0 喉癌喉功能保留手术 fur -->


    

【摘要】 目的 对早期喉癌和癌前病变的临床诊断和病理诊断标准及微创伤治疗后的临床效果进行总结和探讨。方法 临床诊断并经病理证实的32例早期声门癌(T₁ N₀ M₀ )及20例癌前病变在显微支撑喉镜下接受粘膜剥脱及声带切除与微波处理微创伤治疗。结果 经3年随访,26例早期癌术后未见异常,3例复发,2例再次行剥脱术。20例声带癌前病变分为声带白斑、轻度不典型增生、中度不典型增生、重度不典型增生。手术剥脱后经3年随访无一例转为恶性。结论 ①早期喉癌和癌前病变的临床鉴别诊断非常重要,常常几种病理形态共存,过小的活检组织有漏诊之虞，采用剥脱手术,即是确切诊断的方法又是有效治疗的措施,并能恢复正常发音功能；②对于声带活动稍有减弱的声带肿瘤，其减弱原因可能与肿瘤重力压迫有关,不应放弃粘膜剥脱的微创性治疗；③手术后患者的密切随访是至关重要的。

Minimally invasivetreatment in early glottic cancer and vocal cord dysplasia

ZHANG Xiaobo, LIU Dandan,YANG Dazhang, et al. China-Japan Friendship Hospital,Beijing 100029

【Abstract】 Objective Toinvestigate the pathologic and clinical diagnosis of early stage glottic carcinoma and thevocal cord dysplasia and the results of the minimally invasive treatment. Methods Thirty-twocases of early glottic cancer(T₁ N₀ M₀ ) and 20 cases ofvocal dysplasia were treated with mucous stripping and minimally invasive cordectomy underthe micro-suspension laryngoscope. The pathomorphology was observed with continuoussections. Results After 3-4 years follow-up, 26 cases of early glotticcancer remained tumor free, 3 cases relapsed and 2 cases received the re-strippingoperation. twenty cases of vocal cord dysplasia were classified as: leucoplakia of vocalcord, mild atypical hyperplasia, moderate atypical hyperplasia and advanced hyperplasia.None of them had malignant change after 3 years follow-up. Conclusion Thelaryngeal micro-opreation under the micro-suspension laryngoscope is an effective and safecure procedure, it provides a definite diagnostic method for the early stage glotticcarcinoma and the vocal cord dysplasia.

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