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[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。
[Objective] To investigate the effect of local application of chitosan on vocal cord adhesion in the treatment of T1b glottic cancer. [Method] 131 cases of T1b glottic cancer were randomly divided into 2 groups: operation plus chitosan group underwent laryngoscope vocal cord surgery, supplemented with topical chitosan; control group with support laryngoscope Vocal cord lesions removed, the local use of saline. The patients were followed up for 3 years and the clinical effect was evaluated according to the electronic laryngoscope results. [Results] The 3-year survival rate of local application of chitosan group was 95.6% (66/69), while the 3-year survival rate of control group was 93.5% (58/62). There was no significant difference between the two groups (P > 0.05). The rate of postoperative recurrence in locally chitosan group was 10.1% (7/69), while that in control group was 11.3% (7/62). There was no significant difference between the two groups (P> 0.05). The incidence of bilateral vocal cord adhesion in patients with topical chitosan was 2.9% (2/69), while that in the control group was 14.5% (9/62), the difference was statistically significant ( P <0.05). [Conclusion] The application of chitosan locally after bilateral vocal cord can reduce vocal cord adhesion and improve the recovery effect, which can be used as adjuvant therapy for bilateral vocal cord surgery.