【摘要】 目的 探讨低温等离子射频消融术联合CO₂激光治疗对早期声门喉癌患者肿瘤相关因子、嗓音质量、并发症及复发率的影响。方法 收集2020-01-01-2023-02-28郑州大学第一附属医院收治的93例早期声门喉癌患者临床资料，根据治疗方法分为联合组（47例）和激光组（46例）。联合组采用低温等离子射频消融术联合CO₂激光治疗，激光组采用CO₂激光微创治疗，比较两组肿瘤相关因子、嗓音质量、并发症及复发率。结果 术后2周，联合组患者血清血管内皮生长因子（VEGF）、转化生长因子-β1（TGF-β1）、肿瘤坏死因子-α（TNF-α）、β2微球蛋白（β2-MG）分别为（212.45±32.42） ng/L、（34.52±5.42）μg/L、（76.45±10.12） ng/L和（43.24±7.12） mg/L,低于激光组的（265.32±37.45） ng/L、（46.45±6.34）μg/L、（91.44±11.23） ng/L和（56.45±7.56） mg/L,t值分别为7.281、9.761、6.765和8.676,均P<0.001。两组术前、术后2周、术后1个月、术后3个月基频、基频微扰、振幅微扰和谐噪比组别、时间主效应差异均有统计学意义，其中术后2周、1个月、3个月，联合组基频、基频微扰、振幅微扰低于激光组，谐噪比高于激光组，F_组别分别为4.022、7.470、4.215和3.917,P_组别分别为0.045、0.006、0.040和0.048;F_时间分别为12.496、21.928、6.723和5.652,P_时间分别为<0.001、<0.001、<0.001和0.001。随访12个月，联合组患者并发症发生率和复发率分别为10.64%和2.13%,低于激光组的28.26%和13.04%,χ²值分别为4.625和3.980,P值分别为0.032和0.046。结论 低温等离子射频消融术联合CO₂激光治疗可以改善早期声门喉癌患者肿瘤相关因子水平、促进嗓音质量恢复，减少术后并发症及复发率。更多还原

【Abstract】 Objective To explore the effects of low-temperature plasma radiofrequency ablation combined with CO₂laser therapy on tumor related factors,voice quality,complications and recurrence rate in patients with early glottic laryngeal cancer.Methods Clinical data of 93patients with early-stage glottic laryngeal cancer admitted to the First Affiliated Hospital of Zhengzhou University from January 1,2020,to February 28,2023,were collected.Based on the treatment method,they were divided into a combined group（47cases）and a laser group （46cases）.The combined group underwent low-temperature plasma radiofrequency ablation combined with CO₂laser therapy,while the laser group received CO₂laser minimally invasive treatment.Tumor-related factors,voice quality,complications,and recurrence rates were compared between the two groups.Results Two weeks postoperation,the serum levels of vascular endothelial growth factor（VEGF）,transforming growth factor-β1（TGF-β1）,tumor necrosis factor-α（TNF-α）,andβ2-microglobulin（β2-MG）in the combined group were（212.45±32.42）ng/L,（34.52±5.42）μg/L,（76.45±10.12）ng/L and（43.24±7.12）mg/L,respectively,which were significantly lower than those in the laser group’s（265.32±37.45）ng/L,（46.45±6.34）μg/L,（91.44±11.23）ng/L,and（56.45±7.56）mg/L,t values were 7.281,9.761,6.765and 8.676,respectively;all P<0.001.For fundamental frequency （F0）,jitter,shimmer,and harmonic-to-noise ratio（HNR）,both group and time main effects were statistically significant at preoperation,2-week,1-month,and 3-month postoperative assessments.Specifically,at 2weeks,1month,and 3months postoperatively,the combined group exhibited lower F0,jitter,and shimmer but higher HNR compared to the laser group,F_groupvalues were 4.022,7.470,4.215and 3.917,P_groupvalues were 0.045,0.006,0.040and 0.048;F_timevalues were 12.496,21.928,6.723and 5.652,P_timevalues were<0.001,<0.001,<0.001and 0.001,respectively.During the 12-month follow-up,the combined group had significantly lower complication and recurrence rates（10.64%and 2.13%,respectively）than the laser group （28.26%and 13.04%），χ² values were 4.625and 3.980,Pvalues were 0.032and 0.046,respectively.Conclusion Low temperature plasma radiofrequency ablation combined with CO₂laser therapy can improve tumor related factor levels,promote voice quality recovery,and reduce postoperative complications and recurrence rates of early glottic laryngeal cancer patients.更多还原