本文選題：聲帶手術(shù)　切入點(diǎn)：創(chuàng)傷性肉芽腫　出處：《大連醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:通過對聲帶手術(shù)后創(chuàng)傷性肉芽腫的患者給予口服葡萄糖酸鋅治療,從而探討葡萄糖酸鋅治療創(chuàng)傷性肉芽腫的可行性與有效性。方法:回顧性分析2013年1月至2015年12月于大連市中心醫(yī)院耳鼻咽喉科就診的經(jīng)病理活檢確診為聲帶手術(shù)后創(chuàng)傷性肉芽腫62例患者,對患者進(jìn)行分組治療,采用口服葡萄糖酸鋅的40例患者(同時(shí)依據(jù)肉芽腫分度大小劃分為A組22例與B組18例)作為藥物組,治療期限6個月,治療后隨訪時(shí)間為1年;未經(jīng)任何治療的12例患者作為空白對照組,隨訪時(shí)間為1年;同時(shí)將10例愿意接受手術(shù)治療的患者作為手術(shù)組,采用經(jīng)內(nèi)鏡支撐喉鏡下手術(shù)治療,術(shù)后給予霧化吸入1周及聲帶休息2周,隨訪1年。所有患者咽喉反流陰性,病變都發(fā)生于聲帶手術(shù)術(shù)區(qū),且均為初次確診,確診前都未行任何干預(yù)治療。結(jié)果:藥物組40例患者中,治愈34例,有效4例,無效2例,治愈率為85%,空白對照組12例患者中,治愈2例,有效1例,無效9例,治愈率為16.67%;手術(shù)組10例患者,4例治愈,有效3例,無效3例,治愈率40%;藥物組與空白對照組的治愈率差異有統(tǒng)計(jì)學(xué)意義,藥物組與手術(shù)組的治愈率差異有統(tǒng)計(jì)學(xué)意義。其中在藥物組40例患者中,A組22例,治愈18例,有效3例,無效1例,治愈率為81.82%,B組18例,治愈16例,有效1例,無效1例,治愈率為88.89%,兩組治愈率的差異無統(tǒng)計(jì)學(xué)意義。在隨訪期間,藥物組患者中無1例復(fù)發(fā),手術(shù)組中6例復(fù)發(fā),藥物組與手術(shù)組的復(fù)發(fā)率差異有統(tǒng)計(jì)學(xué)意義。結(jié)論:口服葡萄糖酸鋅對聲帶手術(shù)后創(chuàng)傷性肉芽腫的治療有效,其治愈率的高低與肉芽腫的大小無關(guān);與手術(shù)治療相比,對于聲帶手術(shù)后創(chuàng)傷性肉芽腫的治療,口服葡萄糖酸鋅是一種安全、經(jīng)濟(jì)、有效、復(fù)發(fā)率低,更易被患者所接受的療法,值得在臨床上廣泛應(yīng)用。
[Abstract]:Objective: to treat patients with traumatic granuloma after vocal cord surgery by oral administration of zinc gluconate. To explore the feasibility and effectiveness of zinc gluconate in the treatment of traumatic granuloma methods: from January 2013 to December 2015 in Department of Otolaryngology and Otorhinolaryngology, Dalian City Center Hospital, the diagnosis of vocal cord hand by pathological biopsy was retrospectively analyzed. Postoperative traumatic granuloma in 62 patients, 40 patients with zinc gluconate (22 patients in group A and 18 patients in group B) were divided into two groups according to granulomatous grading. The duration of treatment was 6 months and the follow-up time was 1 year. Twelve patients without any treatment were followed up for one year as a blank control group, while 10 patients who were willing to undergo surgery were treated with endoscopic laryngoscope. One week of atomization inhalation and 2 weeks of rest of vocal cord were given after operation. All the patients were followed up for 1 year. All the patients had negative throat reflux and the lesion occurred in the area of vocal cord surgery, and all of them were diagnosed for the first time. Results: in the drug group, 34 cases were cured, 4 cases effective, 2 cases ineffective, and the cure rate was 85%. In the blank control group, 2 cases were cured, 1 case was effective, 9 cases were ineffective. The cure rate was 16.67. In the operation group, 4 patients were cured, 3 patients were effective, 3 patients were ineffective, and the cure rate was 40.The difference of cure rate between the drug group and the blank control group was statistically significant. There was significant difference in the cure rate between the drug group and the operation group, in which 22 cases were cured, 18 cases were cured, 3 cases were effective, 1 case was ineffective, the cure rate was 81.82% in group B, 16 cases were cured, 1 case was effective, and 1 case was ineffective, among them, the cure rate was 81.82%, 16 cases were cured, 1 case was effective, and 1 case was ineffective. The cure rate was 88.89. There was no significant difference in the cure rate between the two groups. During the follow-up period, there was no recurrence in the drug group and 6 cases in the operation group. Conclusion: oral zinc gluconate is effective in the treatment of traumatic granuloma after vocal cord surgery, and the cure rate is not related to the size of granuloma. For the treatment of traumatic granuloma after vocal cord surgery, oral zinc gluconate is a safe, economical, effective, low recurrence rate, more easily accepted by patients, it is worth to be widely used in clinical.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R767.91
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本文編號：1681178