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目的 :探讨在喉部支架完整保留状态下 ,以CO2 激光手术对声带多种疾病行不同术式治疗后的嗓音功能改变。方法 :以CO2 激光对 5 0例喉角化症及白斑病患者行局部病变粘膜切除 ;对 90例声门癌行声带粘膜剥脱 30例 ,声带切除 6 0例。比较不同术式的嗓音声学、气流动力学及频闪喉镜下嗓音功能特点。结果 :局部病变粘膜切除术后 ,嗓音声学检测接近正常 (P >0 .0 5 ) ,声带剥脱术后 ,基频、基频微扰、振幅微扰与正常比较差异有显著性意义 (P <0 .0 5 ) ,谐噪比与正常比较差异有非常显著性意义 (P <0 .0 1) ;声带切除术后 ,嗓音声学参数与正常比较差异有非常显著性意义 (P <0 .0 1)。结论 :随着CO2 激光治疗深度的渐进 ,声带体层受累加重时 ,声带振动功能逐渐丧失 ,但代偿机制逐渐发挥作用 ,嗓音功能发生本质变化。
OBJECTIVE: To investigate the changes of vocal function after different surgical treatment of various diseases of vocal cord with CO2 laser surgery under the condition of intact laryngeal stent. Methods: Fifty cases of laryngeal keratosis and vitiligo were treated by CO2 laser. Local mucosal resection was performed in 50 patients with glottic carcinoma and 30 cases of vocal cord mucosa exfoliation and 60 cases of vocal cord excision. Comparison of different surgical voice acoustics, aerodynamic and laryngoscope voice features. Results: After the local lesion mucosal resection, the voice acoustics was close to normal (P> 0.05). After the vocal cord ablation, the fundamental frequency, fundamental frequency perturbation and amplitude perturbation had significant difference compared with the normal one (P < 0 .0 5). There was a significant difference between the harmonic ratio and the normal one (P <0.01). After the vocal cord excision, the voice acoustics parameters were significantly different from the normal ones (P <0. 0 1). CONCLUSIONS: As the depth of CO2 laser treatment gradually increases, the vocal cord vibration function gradually loses as the vocal cord layer gets worse. However, the compensatory mechanism gradually comes into play and the voice function has an essential change.