目的:探讨激光手术治疗喉部前连合疾病时,既可以切除病变,又可以避免术后粘连、喉狭窄及呼吸困难的较理想手术方法。方法:将12只实验犬随机分成A、B、C、D 4组,每组3只。A组分2次手术切除实验犬前连合,间隔时间为2周;B组一次性切除前连合,同时以硅胶膜片缝合固定于前连合处,2周后拆除硅胶膜;C组一次性切除前连合,术后前连合创面涂丝裂霉素-C;D组一次性切除前连合,术后创面不做其他处理。结果:全部实验犬均在激光下顺利按计划完成手术,术后4周创面观察:A组创面有新生黏膜覆盖,炎症反应轻,前连合无明显粘连;B组创面黏膜覆盖,局部见暗红色慢性炎症改变,前连合轻度粘连;C组创面黏膜覆盖,术区水肿,前连合中度粘连;D组术区肿胀,前连合明显粘连。A、B、C、D 4组犬吠均有不同程度的声嘶,A组最轻,B、C组次之,D组最重。4组实验犬声带长度资料分析:A、B、C组声带长度术后较术前缩短不明显(P>0.05),D组声带长度术后较术前明显缩短(P<0.01);不同处理组间声带长度变化有差异,经两两比较,A组效果最好,B、C组次之,两者之间无明显差异。4组实验犬声门面积资料分析:A、B 2组声门面积术前术后变化不明显(P>0.05),C、D 2组声门面积术后较术前明显缩小(P<0.05);组间比较采用重复测量方差分析(P>0.05),尚不能认为4组之间声门面积变化有明显差异。结论:激光手术切除实验犬前连合,A组防止术后粘连效果最好,B、C组次之。本实验结果对临床中应用激光治疗侵犯至前连合病变的术式选择有一定的参考价值。 Objective: To investigate the laser surgery for pre-laryngeal commissural disease, both lesions can be removed, but also to avoid postoperative adhesions, laryngeal stenosis and dyspnea more ideal surgical methods. Methods: Twelve experimental dogs were randomly divided into A, B, C and D 4 groups, with 3 rats in each group. A group of 2 surgical resection of canine anterior commissure, the interval was 2 weeks; B group a one-time resection before commissure, while the suture was fixed to the anterior commissure with silicone film, 2 weeks after the removal of silicone film; C group A one-time resection before the commissure, postoperative anterior commissure wound coated mitomycin-C; D group a one-time resection before commissure, postoperative wounds without other treatment. Results: All the dogs were successfully operated according to plan under the laser. The wounds were observed 4 weeks after operation. The wounds in group A were covered with nasal mucosa, the inflammatory reaction was light and there was no obvious adhesions in the anterior commissure. The wounds in group B were covered with mucosa, Red chronic inflammation change, anterior commissure mild adhesions; C group wound mucosa coverage, area edema, anterior commissure moderate adhesions; D group swelling, anterior commissure significantly adhesions. A, B, C, D group barks have varying degrees of hoarseness, A group was the lightest, B, C group followed, D group heaviest. Data analysis of vocal cord length in 4 dogs: In group A, B and C, the vocal cord length was not significantly shorter than that before operation (P> 0.05), but the length of vocal cord in group D was significantly shorter than that before operation (P <0.01) There were differences in vocal cord length between the two groups. The results of group A were the best, group B and C were the second, and there was no significant difference between them. The data of the glottic area of ​​the 4 groups were analyzed: The changes of the glottic area in group A and B 2 were not significant before and after operation (P> 0.05), but were significantly decreased in group C and D 2 after operation ). Repeated measures analysis of variance (ANOVA) was used to compare between two groups (P> 0.05). However, there was no significant difference in glottal area between the four groups. Conclusion: Laser surgery resection canine anterior commissure, A group to prevent postoperative adhesions best, followed by B, C group. The results of this experiment on the clinical application of laser treatment of violations of the anterior commissural lesions of surgical options have some reference value.