【摘要】 [目的]探讨局部应用医用几丁糖在预防T1b期声门型喉癌术后声带粘连中的作用。[方法]将131例T1b期声门型喉癌患者随机分为2组:手术加几丁糖组在行支撑喉镜下声带手术后,辅以局部应用几丁糖;对照组行支撑喉镜下声带病变切除,局部使用生理盐水。术后对患者随访3年并根据电子喉镜结果评价其临床效果。[结果]局部应用几丁糖组患者术后3年生存率为95.6%(66/69),而对照组3年生存率为93.5%(58/62),两组差异无统计学意义(P>0.05)。局部应用几丁糖组患者术后复发率为10.1%(7/69),而对照组术后复发率为11.3%(7/62),两组差异无统计学意义(P>0.05)。局部应用几丁糖组患者术后双侧声带粘连的发生率为2.9%(2/69),而对照组术后声带粘连的发生率为14.5%(9/62),差异具有统计学意义(P<0.05)。[结论]双侧声带术后局部应用几丁糖可以减少声带粘连,提高恢复效果,可作为双侧声带手术的辅助治疗方法之一。更多还原

【Abstract】 [Purpose] To investigate the preventive effect of medical chitosan on postoperative vocal cords adhesion in glottic laryngeal carcinoma T 1b stage.[Method] One hundred thirty-one patients with glottic laryngeal carcinoma T 1b stage were divided into two groups. One group used medical chitosan after microscopic suspension laryngoscope surgery,the other group used sodium chloride after the surgery. The effect was evaluated after follow up for 3 years based on electrolaryngoscopy.[Results] The 3-year survival rate was 95.6%(66/69) in patients using medical chitosan,while it was 93.5%(58/62) in patients using sodium chloride,without significant difference between the two groups. The recurrence rate was 10.1% (7/69) in patients using medical chitosan,while it was 11.3% (7/62) in patients using sodium chloride,without significant difference between the two groups. Two in 69 patients(2.9%) using medical chitosan suffered vocal cords adhesion,while 9 in 62 patients (14.5%) using sodium chloride suffered vocal cords adhesion, with significant difference between the two groups. [Conclusion] Medical chitosan can be used for decreasing vocal cords adhesion after laryngomicroscopic surgery for patients with glottic laryngeal carcinoma T 1b stage,and is one of the adjuvant management for bilateral vocal cord surgery.更多还原