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摘要: 目的 探讨脂肪干细胞胶(SVF-gel)在单侧声带麻痹临床应用中的治疗效果。方法 回顾性研究自2017年6月-2018年12月在东南大学医学院附属南京同仁医院耳鼻咽喉头颈外科进行声带SVF-gel自体移植治疗的22例单侧声带麻痹患者的临床资料。全身麻醉支撑喉镜下, 选取大腿内侧作为脂肪供区, 采用SVF-gel技术获取SVF-gel, 并将得到的SVF-gel移植于声带肌及声门旁间隙。分别于术前和术后进行喉成像检查, 并进行嗓音学分析对比, 评价治疗效果。结果 22例手术均成功移植SVF-gel; 频闪喉镜检查见声带振动良好, 声门闭合正常; GRBAS结果显示术后12个月及18个月患者嗓音质量明显改善; 嗓音学分析显示术后12、18个月患者的最长发声时间增加, 基频升高, 基频微扰、振幅微扰及标准化噪声能量较术前明显下降(P < 0.05)。结论 声带SVF-gel自体移植治疗单侧声带麻痹可有效改善其嗓音质量, 且远期疗效稳定。Abstract: Objective To investigate the therapeutic effect of SVF-gel in unilateral vocal cord paralysis.Methods his investigation presented a retrospective study of SVF-gel auto-transplantation in 22 patients with unilateral vocal cord paralysis from June 2017 to December 2018 in otolaryngology head and neck surgery of Nanjing Tongren Hospital. Under the general anesthesia support laryngoscope, the medial thigh was selected as the fat supply area. SVF-gel was obtained by SVF-gel technology. The SVF-gel was transplanted into the vocal cord muscle and the paraglottic space. The laryngography was performed before and after the operation. The voice was analyzed and compared to evaluate the therapeutic effect.Results SVF-gel was successfully transplanted in all 22 cases. The stroboscopic laryngoscopy showed that the vocal cords vibrated well and the glottis closed normally. The results of GRBAS showed that the voice quality of the patients at 12 and 18 months after the operation was significantly improved. The voice analysis showed that the maximum phonation time of the patients at 12 and 18 months after the operation increased. The basic frequency increased. The basic frequency perturbation, amplitude perturbation and standardized noise energy decreased significantly(P < 0.05).Conclusion SVF-gel auto-transplantation can effectively improve the voice quality of unilateral vocal cord paralysis and the long-term effect is stable.
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Key words:
- SVF-gel /
- vocal cord paralysis /
- autotransplant
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表 1 22例患者术前术后GRBAS评级
正常 轻度异常 中度异常 重度异常 术前 0 14 6 2 术后1个月 3 15 4 0 术后12个月 17 3 2 0 术后18个月 19 2 1 0 
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表 2 22例患者术前术后嗓音学分析
x±s 组别 MPT/s F0/Hz Jitter/% Shimmer/% NNE/dB 男性(n=9) 术前 4.67±1.47 146.65±12.43 0.73±0.47 4.26±1.94 -5.38±3.48 术后1个月 13.73±2.25 140.26±19.22 0.71±0.37 4.13±1.55 -7.01±3.77 术后12个月 11.63±1.671) 164.36±23.231) 0.37±0.121) 2.23±1.341) -13.11±4.421) 术后18个月 11.38±1.221) 169.49±19.231) 0.33±0.171) 2.41±1.171) -13.95±3.481) 女性(n=13) 术前 5.11±2.03 210.26±29.23 0.78±0.23 3.53±1.54 -5.70±4.41 术后1个月 14.44±2.33 218.26±27.44 0.76±0.17 3.02±1.63 -6.11±3.29 术后12个月 12.74±1.771) 224.78±19.631) 0.42±0.211) 2.11±1.591) -12.34±3.481) 术后18个月 12.01±2.091) 229.78±23.231) 0.39±0.181) 2.06±1.221) -12.11±3.821) 与术前比较，P < 0.05。
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