本文選題：聲帶息肉　切入點(diǎn)：纖維鼻咽喉鏡　出處：《浙江大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的 比較表面麻醉纖維鼻咽喉鏡與全身麻醉顯微鏡支撐喉鏡下對(duì)不同類型聲帶息肉摘除的臨床療效。 方法 回顧性分析浙江大學(xué)附屬邵逸夫醫(yī)院2010年11月～2012年10月收治的164例聲帶息肉患者臨床資料,66例患者采用表面麻醉纖維鼻咽喉鏡下聲帶息肉摘除術(shù)(表面麻醉纖維鼻咽喉鏡組,廣基息肉27例、帶蒂息肉39例),98例患者采用全身麻醉顯微鏡支撐喉鏡下聲帶息肉摘除術(shù)(全身麻醉顯微鏡支撐喉鏡組,廣基息肉50例、帶蒂息肉48例)。 結(jié)果 表面麻醉纖維鼻咽喉鏡組與全身麻醉顯微鏡支撐喉鏡組平均手術(shù)時(shí)間依次為(35.6±12.3)分鐘、(46.5士17.6)分鐘,兩組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)；對(duì)于帶蒂聲帶息肉病人,兩組術(shù)后聲學(xué)參數(shù)的變化,沒(méi)有明顯差異(P0.05)；對(duì)于廣基聲帶息肉病人,兩組術(shù)后聲學(xué)參數(shù)的變化,有明顯差異,全身麻醉顯微鏡支撐喉鏡組效果優(yōu)于表面麻醉纖維鼻咽喉鏡組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。全身麻醉顯微鏡支撐喉鏡組不良并發(fā)癥發(fā)生率為7.1%,稍高于表面麻醉纖維鼻咽喉鏡組(4.5%),但無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。 結(jié)論 1:對(duì)于不同類型聲帶息肉,從手術(shù)時(shí)間上看,我們認(rèn)為表面麻醉纖維鼻咽喉鏡下手術(shù)時(shí)間明顯少于全身麻醉顯微鏡支撐喉鏡下手術(shù)時(shí)間；2:對(duì)不同類型聲帶息肉采取不同術(shù)式治療后嗓音參數(shù)分析,我們認(rèn)為對(duì)于廣基聲帶息肉,從手術(shù)療效上選擇術(shù)式,顯微喉外科手術(shù)是最佳選擇,對(duì)于帶蒂聲帶息肉,顯微鏡支撐喉鏡下手術(shù)和纖維鼻咽喉鏡下手術(shù),療效相同。嗓音聲學(xué)分析可以作為聲帶息肉病變手術(shù)方式選擇、手術(shù)療效評(píng)價(jià)、術(shù)后嗓音恢復(fù)情況判定的一個(gè)客觀參考依據(jù)。
[Abstract]:Purpose. To compare the clinical effect of surface anesthesia fiber nose laryngoscope and general anesthesia microscope supporting laryngoscope on different types of vocal cord polyp removal. Method. The clinical data of 164 patients with vocal cord polyps treated by run run run Shaw Hospital affiliated to Zhejiang University from November 2010 to October 2012 were retrospectively analyzed. 66 patients with vocal cord polyps were treated with surface anesthesia fiber rhinolaryngoscope (superficial anesthesia fiber rhinolaryngoscope group). Twenty-seven cases of wide base polyps and 39 cases of pedicle polyps were treated with laryngoscope supported by general anesthesia microscope (50 cases with wide base polyps and 48 cases with pedicle polyps). Results. The average operative time of the fiberoptic laryngoscope group and the general anesthesia microscope support laryngoscope group was 35.6 鹵12.3 minutes, 46.5 鹵17.6 minutes respectively. The difference was statistically significant (P 0.05) for the patients with vocal cord polyps with pedicle. There was no significant difference in the changes of acoustic parameters between the two groups after operation (P 0.05). For the patients with wide base vocal cord polyps, there were significant differences in the postoperative acoustic parameters between the two groups. The effect of general anesthesia microscope supporting laryngoscope group was better than that of surface anesthesia fiber nasopharyngeal laryngoscope group. The incidence of adverse complications in general anesthesia microscope supported laryngoscope group was 7.1, which was slightly higher than that in surface anesthesia fiber nasopharyngeal laryngoscope group (4.5%), but there was no statistical difference (P 0.05). Conclusion. 1: for different types of vocal cord polyps, from the point of view of operation time, We think that the operating time under fiber nose laryngoscope under surface anesthesia is much shorter than that under laryngoscope supported by general anesthesia microscope: analysis of voice parameters after different types of vocal cord polyps treated with different methods. We think that microlaryngectomy is the best choice for polyps with broad base vocal cord, microlaryngectomy is the best choice for polyps with pedicle vocal cord, microlaryngoscope and fibro-nasolaryngoscope are the best choice for polyp of broad base vocal cord. The voice acoustic analysis can be used as an objective reference for the selection of surgical methods for vocal cord polyp lesions, the evaluation of surgical efficacy and the evaluation of postoperative voice recovery.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R767.91

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 趙加銀;表面麻醉支撐喉鏡下聲帶息肉摘除41例分析[J];江蘇大學(xué)學(xué)報(bào)(醫(yī)學(xué)版);2003年02期

2 艾永凱;王瑛;劉欣;;麻醉誘導(dǎo)藥物用于支撐喉鏡下聲帶息肉摘除262例[J];西部醫(yī)學(xué);2007年01期

3 黃順德;;全麻纖維喉鏡下聲帶息肉摘除的臨床應(yīng)用前景探討[J];中外醫(yī)療;2012年26期

4 林常紅;張麗莉;劉丹;;丁卡因用于預(yù)防全身麻醉下聲帶息肉摘除所致喉痙攣的效果觀察[J];護(hù)理研究;2008年02期

5 葉蓮妹，林熹;間接喉鏡下聲帶息肉摘除226例分析[J];福建醫(yī)藥雜志;1995年05期

6 胡立喬，劉景池;間接喉鏡下聲帶息肉摘除62例[J];桂林醫(yī)學(xué)院學(xué)報(bào);1995年02期

7 崔劍;陶國(guó)才;劉德行;王恩勤;汪玉林;楊敬濤;王淑瓊;王自偉;;不同部位黏膜麻醉輔助全麻下聲帶息肉摘除的效果觀察[J];臨床麻醉學(xué)雜志;2008年01期

8 甘鳳霜;;對(duì)96例行聲帶息肉摘除+咽部激光治療術(shù)的患者進(jìn)行圍手術(shù)期護(hù)理的效果觀察[J];求醫(yī)問(wèn)藥(下半月);2012年12期

9 吳龍軍;黃益燈;麻瓊釩;;環(huán)甲膜切開(kāi)巨大聲帶息肉摘除1例[J];中國(guó)耳鼻咽喉頭頸外科;2013年03期

10 彭程,朱堅(jiān)忠;靜吸復(fù)合全麻用于支撐喉鏡下聲帶息肉摘除[J];海南醫(yī)學(xué)院學(xué)報(bào);2000年04期

相關(guān)碩士學(xué)位論文 前1條

1 趙權(quán);不同手術(shù)方式對(duì)不同類型聲帶息肉摘除的臨床療效分析[D];浙江大學(xué);2014年

，

本文編號(hào)：1578038