布地奈德联合显微支撑喉镜低温等离子射频消融术治疗早期声门型喉癌患者的临床研究OA

Objective To observe the clinical efficacy and safety of combining nebulized budesonide suspension with microscopic support laryngoscope cool plasma radiofrequency ablation in the treatment of early glottic carcinoma(EGC).Methods EGC patients were divided into control group and treatment group based on different treatment regimens.Both groups underwent microscopic support laryngoscope cool plasma radiofrequency ablation.Postoperatively,the control group was administered oral cefaclor extended-release capsules at a dose of 0.5 g per time,twice daily,for 2 consecutive days.The treatment group was given inhaled budesonide suspension at a dosage of 1 mg for nebulization,twice a day,starting one week after surgery,and after one week,switched to nebulization with saline for 3 weeks based on control group.The clinical efficacy,laryngeal morphological indicators,objective voice acoustic indicators,voice disorder index and postoperative follow-up results were compared between the two groups,and conducted a safety assessment.Results A total of 98 patients were included,51 in control group and 47 in treatment group.After treatment,the overall effective rates for control and treatment groups were 84.31％(43 cases/51 cases)and 89.36％(42 cases/47 cases),respectively,with no statistically significant difference(P＞0.05).At 4 weeks postoperatively,the morphological scores for the vocal folds in control and treatment groups were(1.45±0.73)and(1.13±0.74)points,respectively;the fundamental frequencies were(168.71±22.58)and(158.02±23.83)Hz,respectively;the frequency perturbations were(0.72±0.11)％and(0.67±0.13)％,respectively;the amplitude perturbations were(4.16±0.56)％and(3.89±0.47)％,respectively;the harmonic-to-noise ratios were(21.39±2.32)and(23.34±2.43)dB,respectively;the physiological scores were(18.45±2.89)and(17.00±3.16),respectively,with all differences being statistically significant between the two groups(all P＜0.05).One case of gastrointestinal reaction occurred in control group;one case of rash and two cases of gastrointestinal reaction occurred in treatment group.The total incidence of adverse drug reactions in treatment and control groups were 6.38％(3 cases/47 cases)and 1.96％(1 case/51 cases),respectively,with no statistically significant difference(P＞0.05).The progression-free survival rates for control and treatment groups were 91.30％(42 cases/46 cases)and 95.45％(42 cases/44 cases),respectively,with no statistically significant difference(P＞0.05).Conclusion Nebulized budesonide budesonide inhalation therapy combined with microscopic support laryngoscope cool plasma radiofrequency ablation provides comparable treatment efficacy to isolated microscopic support laryngoscope cool plasma radiofrequency ablation in patients with EGC,but the former demonstrates more significant improvement in vocal fold morphology and voice quality.