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Abstract：
OBJECTIVE: This study was designed to determine the effect of CO2 laser combined with low-temperature plasma radiofrequency ablation (LPRA) on swallowing function and prognosis in elderly patients with early glottic laryngeal cancer (GLC).
METHODS: The clinical data of 115 elderly patients with early GLC treated in General Hospital of Daqing Oil Field from May 2013 to September 2015 were retrospectively analyzed. These patients were assigned to a research group or control group according to different therapeutic regimen. Totally 56 cases treated with CO2 laser resection were assigned to the control group, and 59 cases treated with CO2 laser combined with LPRA were assigned to the research group. The hospital stay, postoperative pain, mucosal recovery score, postoperative complications, swallowing function, vocal function, and 5-year recurrence rate were compared between the two groups. Independent risk factors for 5-year recurrence in patients were analyzed by multivariate logistic regression.
RESULTS: The research group was significantly superior to the control group in terms of hospital stay, postoperative pain, and mucosal recovery score (P<0.05), and the postoperative complication rate was not significantly different between the two groups (P>0.05). After treatment, the research group showed better swallowing function and vocal function than the control group, and the 5-year recurrence rate of the two groups was similar (P=0.288). Multivariate logistic regression analysis identified higher age, lower differentiation, and presence of a cumulative anterior commissure as independent risk factors for recurrence.
CONCLUSIONS: CO2 laser combined with LPRA can provide relatively high clinical efficacy for early GLC in the elderly, after which patients\' swallowing function and vocal function recover quickly, but the long-term benefit of adding LPRA is not evident.
METHODS: The clinical data of 115 elderly patients with early GLC treated in General Hospital of Daqing Oil Field from May 2013 to September 2015 were retrospectively analyzed. These patients were assigned to a research group or control group according to different therapeutic regimen. Totally 56 cases treated with CO2 laser resection were assigned to the control group, and 59 cases treated with CO2 laser combined with LPRA were assigned to the research group. The hospital stay, postoperative pain, mucosal recovery score, postoperative complications, swallowing function, vocal function, and 5-year recurrence rate were compared between the two groups. Independent risk factors for 5-year recurrence in patients were analyzed by multivariate logistic regression.
RESULTS: The research group was significantly superior to the control group in terms of hospital stay, postoperative pain, and mucosal recovery score (P<0.05), and the postoperative complication rate was not significantly different between the two groups (P>0.05). After treatment, the research group showed better swallowing function and vocal function than the control group, and the 5-year recurrence rate of the two groups was similar (P=0.288). Multivariate logistic regression analysis identified higher age, lower differentiation, and presence of a cumulative anterior commissure as independent risk factors for recurrence.
CONCLUSIONS: CO2 laser combined with LPRA can provide relatively high clinical efficacy for early GLC in the elderly, after which patients\' swallowing function and vocal function recover quickly, but the long-term benefit of adding LPRA is not evident.
摘要：
目的：本研究旨在确定CO2激光联合低温等离子射频消融（LPRA）对老年早期声门喉癌（GLC）患者吞咽功能和预后的影响。
方法：对2013年5月至2015年9月大庆油田总医院收治的115例老年早期GLC患者的临床资料进行回顾性分析。根据不同的治疗方案将这些患者分为研究组或对照组。将56例采用CO2激光切除的患者分为对照组。59例采用CO2激光联合LPRA治疗。住院，术后疼痛,粘膜恢复评分,术后并发症,吞咽功能,声乐功能，比较两组5年复发率。采用多因素logistic回归分析患者5年复发的独立危险因素。
结果:研究组住院时间明显优于对照组,术后疼痛,粘膜恢复评分(P<0.05),两组术后并发症发生率比较差异无统计学意义(P>0.05)。治疗后,研究组吞咽功能和发声功能优于对照组，两组5年复发率相似(P=0.288)。多因素logistic回归分析确定年龄较高，较低的分化，和累积前连合的存在是复发的独立危险因素。
结论：CO2激光联合LPRA治疗老年早期GLC的临床疗效较高，之后，患者吞咽功能和发声功能迅速恢复，但加入LPRA的长期好处并不明显。
方法：对2013年5月至2015年9月大庆油田总医院收治的115例老年早期GLC患者的临床资料进行回顾性分析。根据不同的治疗方案将这些患者分为研究组或对照组。将56例采用CO2激光切除的患者分为对照组。59例采用CO2激光联合LPRA治疗。住院，术后疼痛,粘膜恢复评分,术后并发症,吞咽功能,声乐功能，比较两组5年复发率。采用多因素logistic回归分析患者5年复发的独立危险因素。
结果:研究组住院时间明显优于对照组,术后疼痛,粘膜恢复评分(P<0.05),两组术后并发症发生率比较差异无统计学意义(P>0.05)。治疗后,研究组吞咽功能和发声功能优于对照组，两组5年复发率相似(P=0.288)。多因素logistic回归分析确定年龄较高，较低的分化，和累积前连合的存在是复发的独立危险因素。
结论：CO2激光联合LPRA治疗老年早期GLC的临床疗效较高，之后，患者吞咽功能和发声功能迅速恢复，但加入LPRA的长期好处并不明显。
