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摘要: 目的: 探讨声带息肉的临床特征和病理特点。方法: 回顾性分析经手术治疗的1 116例声带息肉患者的临床及病理资料。结果: 1 116例声带息肉患者,在全身麻醉支撑喉镜悬吊过程中,170例(15.2%)患者出现心率减慢,待停止悬吊、阿托品静脉推注,心率恢复正常后继续完成手术。1 116例声带息肉,治愈1094例(98%),好转22例(2%),无效0例。支撑喉镜咽部无损伤865例(77.5%),轻微损伤139例(12.5%),较重损伤86例(7.7%),严重损伤26例(2.3%)。声带息肉伴上皮非异型增生和异型增生的发生率分别为35.4%和5.0%。男女性患者声带息肉上皮非异型增生和异型增生分别为76.2%、23.8%(P<0.01)和78.6%、21.4%(P<0.01)。男女声带息肉角化和角化不全发生率分别为93.1%、6.9%和93.1%、6.9%,差异有统计学意义(P<0.01)。上皮无增生、上皮伴非异型增生和异型增生患者的角化率分别为2.1%、18.2%和30.3%,数据两两比较均有统计学差异。结论: 声带息肉高发年龄为31~60岁,显微喉镜摘除声带息肉手术效果好,但术中需关注咽部损伤和咽喉迷走反射;男性声带息肉患者容易出现上皮异型增生和角化。Abstract: Objective: The aim of this study is to investigate the clinical and pathological features of vocal cord polyp.Method: Retrospective analyzed the clinical and pathological data of 1 116 cases in vocal cord polyp patients treated with suspension microlaryngoscopic surgery.Result: The bradycardia was observed in 170 cases(15.2%) during the suspension of laryngoscope under general anesthesia. In this case, the suspension was stopped or the laryngoscope was taken out of mouth and atropine was administrated by intravenous injection. After that, heartbeat gradually accelerated and approached to normal, then the suspension was begun again to complete microlaryngoscopic surgery. Among the 1 116 cases, 1 094(98%) were cured, 22(2%) were improved, and no case was invalid. No pharyngeal injury was in 865 cases(77.5%). Mild, moderate and severe palatoglossal arch injury was observed in 139 (12.5%)cases, 86(7.7%)cases, and 26(2.3%) cases, respectively. The incidences of epithelial hyperplasia and dysplasia in vocal cord polyp were 35.3% and 5.0%, respectively. The prevalence rates of epithelial hyperplasia and dysplasia in male and female patients of vocal cord polyp were 76.2%, 23.8% (P<0.01) and 78.6%, 21.4% (P<0.01), respectively. And the prevalence rates of keratinization and parakeratosis in male and female patients were 93.1%, 6.9% (P<0.01) and 93.1%, 6.9% (P<0.01), respectively.The incidence of keratinization in patients of no epithelial hyperplasia, epithelial hyperplasia and epithelial dysplasia were 2.1%, 18.2% and 30.3%, respectively, with significant difference in pairwise comparison.Conclusion: High incidence of vocal cord polyp is at the age from 31 to 60 years old.Although laryngomicrosurgery is an effective treatment for vocal cord polyp, pharyngeal injury and laryngopharyngeal-vagal reflex should be noticed during the operation. In addition, vocal cord polyps in male patients are susceptible to epithelial dysplasia and keratinization.
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Key words:
- vocal cord polyp /
- laryngoscopy /
- pathological feature
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