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  • 徐胜群,庞仕秀,崔相国,姜学钧,杨怀安.支撑喉镜下平阳霉素注射加电刀凝切综合治疗咽喉血管瘤[J].第二军医大学学报,2018,39(6):683-686    [点击复制]
  • XU Sheng-qun,PANG Shi-xiu,CUI Xiang-guo,JIANG Xue-jun,YANG Huai-an.Therapeutic effect of pingyangmycin injection combined with hypercator resection under suspension laryngoscope on laryngopharyngeal hemangioma[J].Acad J Sec Mil Med Univ,2018,39(6):683-686   [点击复制]
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支撑喉镜下平阳霉素注射加电刀凝切综合治疗咽喉血管瘤
徐胜群1,庞仕秀2,崔相国1,姜学钧2,杨怀安1*
0
(1. 中国医科大学附属盛京医院睡眠医学中心, 沈阳 110020;
2. 中国医科大学附属第一医院耳鼻咽喉科, 沈阳 110000
*通信作者)
摘要:
目的 观察支撑喉镜下应用平阳霉素注射加电刀切除综合治疗下咽及喉部血管瘤的临床疗效。方法 选择下咽及喉部血管瘤患者27例。患者经喉插管全身麻醉后,支撑喉镜下显露血管瘤,瘤体内局部注射平阳霉素(8 mg,用5 mL生理盐水注射液稀释),然后应用息肉钳式电刀沿瘤体根底部完整切除瘤体或采用钳夹瘤体电凝的方法完整凝固瘤体。记录术中和术后出血情况,术后进流食2周。分别于术后1个月、3个月、1年、2年、3年复查纤维喉镜判定疗效。结果 瘤体在注射5 mL平阳霉素后由粉红色或紫红色变为粉白色。当钳夹瘤体能够显露根蒂部时,应用息肉钳式电刀沿根底部可完整切除瘤体,术中几乎无血;当无法显露根蒂或根蒂较大时,采用钳夹瘤体电凝的方法可完整凝固瘤体。所有患者术后均无呼吸困难和创面出血。1个月后复查纤维喉镜显示创面为粉红色正常黏膜修复。术后1年随访全部病例均未见复发;术后2年随访,1例患者咽侧壁黏膜再现片状紫色隆起,再次行上述疗法完整切除瘤体;术后3年随访未见复发。结论 下咽及喉部血管瘤经支撑喉镜下局部注射平阳霉素后应用电刀切除的手术方法可一次性切除病变,手术创伤小,恢复快。该治疗方案疗效肯定,易于普及。
关键词:  血管瘤  平阳霉素  支撑喉镜检查  咽疾病  喉疾病
DOI:10.16781/j.0258-879x.2018.06.0683
投稿时间:2018-01-15修订日期:2018-05-11
基金项目:
Therapeutic effect of pingyangmycin injection combined with hypercator resection under suspension laryngoscope on laryngopharyngeal hemangioma
XU Sheng-qun1,PANG Shi-xiu2,CUI Xiang-guo1,JIANG Xue-jun2,YANG Huai-an1*
(1. Department of Sleep Medical Center, Shengjing Hospital of China Medical University, Shenyang 110020, Liaoning, China;
2. Department of Otolaryngology, the First Hospital of China Medical University, Shenyang 110000, Liaoning, China
*Corresponding author)
Abstract:
Objective To observe the clinical effect of pingyangmycin injection combined with hypercator resection on laryngopharyngeal and laryngeal hemangioma under suspension laryngoscope. Methods Twenty-seven patients with laryngopharyngeal or laryngeal hemangioma were included. After trachea cannula via mouth and general anesthesia, the suspension laryngoscope was used to completely uncover the hemangioma, and 8 mg pingyangmycin (diluted with 6 mL saline injection) was locally injected into the tumor. And then the tumor was completely resected along its root by polypus forceps-like hypercator or was completely coagulated by electric coagulation. The intra-operative and post-operative bleeding were recorded, and the patients were given liquid diets after surgery for two weeks. The fibrolaryngoscope was reviewed to judge the curative effect at 1 month, 3 months, 1 year, 2 years, and 3 years after surgery. Results The pink or prunosus tumor turned into pinkish-white tumor after injection of pingyangmycin. When the root pedicle of the tumor was revealed by forceps holder, the polypus forceps-like hypercator could completely resect the tumor along the base of root, nearly without bleeding in the operation; when the root pedicle was big or could not be revealed, the tumor could be completely coagulated by electric coagulation. After surgery, no patients had dyspnea or wound bleeding. One month later, fibrolaryngoscope showed that the wound was repaired with pink normal mucosa. No recurrence was found in all cases after follow-up for 1 year. After 2 years of follow-up, one case had flaky purple uplift of the pharyngeal wall mucosa, and the tumor was completely resected by the above treatment. No recurrence was found after 3 years of follow-up. Conclusion Hypercator resection after local injection of pingyangmycin under suspension laryngoscope can completely resect the lesions, with less surgery trauma and quick recovery, suggesting that the treatment has affirmative efficacy and is worth popularizing.
Key words:  hemangioma  pingyangmycin  suspension laryngoscopy  pharyngeal diseases  laryngeal diseases