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摘要: 目的 分析声带白斑的临床特征及常见病因，探讨其治疗原则。方法 选取157例声带白斑患者，常规行白光喉镜、窄带成像内镜(NBI)、频闪喉镜以及咽喉反流体征评分量表(RFS)、反流症状指数量表(RSI)评估，予以戒烟酒、抑酸、休声等保守治疗和(或)手术治疗。结果 157例声带白斑患者中109例(69.4%)经保守治疗后白斑基本减退或消失，48例行手术治疗，术后病理诊断分别为轻度不典型增生2例(1.3%)、中度不典型增生15例(9.6%)、重度不典型增生或原位癌19例(12.1%)、浸润癌12例(7.6%)。结论 声带白斑经NBI、频闪喉镜检查大多数未见有恶性体征不符合手术适应证，经保守治疗后有效，仅少部分患者有病理组织活检或手术治疗指征，而且大部分患者伴有咽喉反流，抑酸治疗有效，也是治疗的重要环节。Abstract: Objective To study the clinical characteristics and common etiology of vocal cord leukoplakia, and explore the treatment principle.Method One hundred and fifty-seven patients with vocal cord leukoplakia were recruited in this study. They were assessed by routine laryngoscope, narrow band imaging (NBI), stroboscope, reflux finding score (RFs) and reflux symptom index (RSI), and given conservative treatment (smoking cessation, alcohol, acid suppression, sound cessation, etc.) and/or surgical treatment.Result Among 157 patients with leukoplakia of vocal cord, 109 (69.4%) had basically improved or cured after conservative treatment. Forty-eight cases underwent operation. The postoperative pathological diagnosis was mild dysplasia in 2 cases (1.3%), moderate dysplasia in 15 cases (9.6%), severe dysplasia or carcinoma in situ in 19 cases (12.1%), and invasive carcinoma in 12 cases (7.6%).Conclusion NBI and stroboscopic laryngoscopy showed that most of the leukoplakia of vocal cord was non-malignant in nature, which was not in accordance with the indication of operation. Conservative treatment is effective. Biopsy or operation was indicated in only a few patients. Moreover, most of the patients are accompanied by laryngopharyngeal reflux, and the treatment of acid suppression is effective.
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