论文部分内容阅读
目的:初步探讨电子喉镜下喉部碘溶液染色的可行性及对早期喉癌诊断的临床应用价值。方法:将符合纳入标准的90例早期喉癌患者随机分为a、b、c三组。所有患者均采用电子喉镜及窄带成像技术(NBI)模式检查。a组采用0.5%Lugol液碘染色(0.5%Lugol液组),b组采用1.0%Lugol液碘染色(1.0%Lugol液组),c组采用1.5%Lugol液碘染色(1.5%Lugol液组)。分别记录每组中每例患者3种检查方法的阳性病灶位置及范围,对电子喉镜阳性、NBI阳性及碘染色阳性病灶均分别取活检,如果阳性病灶位置重复,该部位只取1次活检。以病理结果作为诊断金标准,将其他检查结果与之作为对照。每组分别观察碘在喉部着色情况,随访所有患者24h内是否存在呼吸困难、严重的咽喉疼痛等不适症状,并于检查后24h再次进行电子喉镜检查。结果:所有患者在碘染色24h后行电子喉镜检查均无明显的咽喉黏膜及声门下方气管黏膜红肿等炎症反应,均表示可以接受,无排斥抵触心理。以1.0%及以下浓度的Lugol液进行碘染色,对早期喉癌诊断的敏感性高于电子喉镜,两者在早期喉癌诊断中差异无统计学意义(P>0.05)。1.5%Lugol溶液碘染色与电子喉镜比较,两者差异有统计学意义(P<0.05);1.5%Lugol溶液碘染色与NBI检查比较,两者差异无统计学意义(P>0.05)。结论:1.5%及以下浓度的Lugol碘溶液在电子喉镜下喉部染色安全可行。1.5%Lugol碘溶液在电子喉镜下的喉部染色对早期喉癌的诊断明显优于电子喉镜,具有一定的临床应用价值。
Objective: To investigate the feasibility of laryngeal iodine staining under electronic laryngoscope and its clinical value in the diagnosis of early laryngeal cancer. Methods: Ninety patients with early laryngeal cancer who met the inclusion criteria were randomly divided into three groups: a, b and c. All patients underwent electronic laryngoscope and narrow band imaging (NBI) mode examination. Group I was stained with iodine 0.5% Lugol (0.5% Lugol), group B was stained with 1.0% Lugol iodine (1.0% Lugol), group C (1.5% Lugol) . The locations and ranges of the positive lesions of each of the three examination methods in each group were recorded respectively. The biopsy specimens were taken from the electronic laryngoscope positive, the NBI positive and the iodine staining positive, respectively. If the positive lesions were located repeatedly, only one biopsy . Pathological results as the gold standard for diagnosis, the other test results as a control. Each group were observed iodine coloring in the larynx, all patients were followed up within 24h breathing difficulties, severe sore throat and other symptoms, and in the examination after 24h electronic laryngoscopy again. Results: All patients underwent electronic laryngoscopy 24 hours after iodine staining showed no obvious inflammatory reaction of the throat mucosa and submucosal tracheal mucosa, all showed acceptable, non-rejection of conflict psychology. Iodine staining with Lugol solution at a concentration of 1.0% or less was more sensitive to the diagnosis of early laryngeal carcinoma than that of electronic laryngoscope. There was no significant difference between the two groups in the diagnosis of early laryngeal carcinoma (P> 0.05). The iodine staining of 1.5% Lugol solution was compared with electronic laryngoscope (P <0.05). The iodine staining of 1.5% Lugol solution was not significantly different from that of NBI (P> 0.05). CONCLUSIONS: Lugol iodine solutions at 1.5% and below are safe and feasible for laryngeal staining under electronic laryngoscopes. The laryngeal staining of the 1.5% Lugol iodine solution under the electronic laryngoscope is superior to the electronic laryngoscope in the diagnosis of early laryngeal cancer, which has a certain clinical value.