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目的:探讨声带癌T_1的CO_2激光治疗与放射治疗对喉发音机能有何不同影响.方法:24例声带癌T_1患者,9例行CO_2激光治疗,7例放射治疗,8例CO_2激光与放射联合治疗.病人治疗前后行频闪喉镜检查,嗓音声学分析(APQ,PPQ,NNEb,NNEa),喉平均呼气流率(MFR)检测及嗓音听觉评价分析.结果:(1)放疗加激光联合治疗对发音功能较单独应用激光或单独应用放疗的影响大.(2)CO_2激光治疗后组嗓音音质改变以粗糙型,气息型为主,放射治疗后组以粗糙型,气息型,紧张型为主.(3)频闪喉镜检查见CO_2激光治疗病人及部分放疗病人出现声门闭合不全,声带振动振幅减小,声带粘膜波消失改变.(4)喉平均呼气流率值在CO_2激光,放疗及激光加放疗联合治疗组间未见统计学显著性差异.结论:用CO_2激光与放射疗法对声带癌丁T_1治疗对喉发音机能的影响无统计学显著性差异.考虑到放疗的周期长,副作用多等缺点,认为对声带癌T_1病人应以CO_2激光治疗为首选.
Objective: To investigate the different effects of CO_2 laser treatment and radiotherapy on the laryngeal sounds in patients with vocal cord cancer T_1.Methods: 24 Tc patients with vocal cord cancer were treated with CO_2 laser, 7 with radiotherapy and 8 with CO_2 laser combined with radiotherapy (APQ, PPQ, NNEb, NNEa), mean throat flow rate (MFR) and voice auditory evaluation were analyzed before and after treatment.Results: (1) Radiotherapy plus laser combined (2) After the CO_2 laser treatment group voice quality changes to rough, breath-based, radiotherapy after treatment group with rough, breath-type, tension-type for the treatment of the pronunciation function than the single application of laser or radiotherapy alone. (3) In the laryngoscopy, laryngoscopy showed that the glottis was closed incompletely, the vibrational amplitude of the vocal cords decreased and the disappearance of the vocal fold mucosal wave changed. (4) The mean laryngopharyngeal flow rate in the CO_2 laser , Radiotherapy and laser plus radiotherapy combined treatment group showed no statistically significant difference.Conclusion: CO_2 laser and radiotherapy on the vocal cord cancer Ding T_1 treatment of laryngeal sound performance was not statistically significant difference.Considering the cycle of radiotherapy Long, many shortcomings and other side effects , That T_1 patients with vocal cord cancer should be CO2 laser treatment for the first choice.