显微支撑喉镜手术联合抑酸治疗声带任克水肿疗效观察

邝韶景; 李忠万; 方红雁; 杨贵军

doi:10.16016/j.1000-5404.202103214

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显微支撑喉镜手术联合抑酸治疗声带任克水肿疗效观察

临床医学 | 更新时间：2026-01-09

- 显微支撑喉镜手术联合抑酸治疗声带任克水肿疗效观察
- Efficacy of microscopic laryngeal surgery combined with gastric acid inhibition in treatment of Reinke's edema
- 第三军医大学学报 2021年43卷第19期页码：1939-1943
- 作者机构：
  
  400014 重庆，重庆市人民医院耳鼻咽喉头颈外科
- 作者简介：
  
  [杨贵军，E-mail: 402681589@qq.com YANG Guijun, E-mail: 402681589@qq.com
- 基金信息：
  
  重庆市社会事业与民生保障科技创新专项(cstc2018jscx-msyb1194)
- DOI：10.16016/j.1000-5404.202103214
  中图分类号： R767.4;R767.91;R975.2
- 收稿：2021-03-25，
  
  修回：2021-05-30，
  
  纸质出版：2021-10-15
- 稿件说明：
移动端阅览
邝韶景, 李忠万, 方红雁, 等. 显微支撑喉镜手术联合抑酸治疗声带任克水肿疗效观察[J]. 第三军医大学学报, 2021,43(19):1939-1943.

Shaojing KUANG, Zhongwan LI, Hongyan FANG, et al. Efficacy of microscopic laryngeal surgery combined with gastric acid inhibition in treatment of Reinke's edema[J]. Journal of Third Military Medical University, 2021, 43(19): 1939-1943.
邝韶景, 李忠万, 方红雁, 等. 显微支撑喉镜手术联合抑酸治疗声带任克水肿疗效观察[J]. 第三军医大学学报, 2021,43(19):1939-1943. DOI： 10.16016/j.1000-5404.202103214.

Shaojing KUANG, Zhongwan LI, Hongyan FANG, et al. Efficacy of microscopic laryngeal surgery combined with gastric acid inhibition in treatment of Reinke's edema[J]. Journal of Third Military Medical University, 2021, 43(19): 1939-1943. DOI： 10.16016/j.1000-5404.202103214.

摘要

目的

探讨显微支撑喉镜手术联合抑酸治疗声带任克水肿的疗效。

方法

回顾性分析2016年4月至2019年12月我科47例术前评估存在咽喉反流的声带任克水肿患者临床资料，根据患者术后抑酸治疗与否分为抑酸组(

=27)和非抑酸组(

=20)，选取同期56例正常噪音者作为健康对照组。对比分析术前及术后1、3、6个月基频(F0)、基频微扰(jitter)、噪/谐比(NHR)、振幅微扰(shimmer)等嗓音功能指标及噪音障碍指数(voice handicap index，VHI)量表评分的变化。

结果

术前两组患者F0低于健康对照组，jitter、NHR、shimmer均高于健康对照组(

0.05)。术后第3、6个月抑酸组F0大于非抑酸组，jitter、shimmer、NHR小于非抑酸组，与健康对照组相比差异有统计学意义(

0.05)。术后1、3、6个月，抑酸及非抑酸组F0逐渐升高，其余3个嗓音声学指标均有一定程度的降低，声音嘶哑逐渐减轻。术后1个月时，抑酸及非抑酸组之间上述指标无明显差异；在第3、6个月时，抑酸组F0大于非抑酸组，NHR、jitter及shimmer小于非抑酸组，差异有统计学意义(

0.05)，抑酸及非抑酸组与健康对照组相比仍存在明显差异(

0.05)。术前两组患者VHI各项评分高于健康对照组，差异具有统计学意义(

0.05)；术后患者单项评分以及总评分逐渐降低，各时间点抑酸组与非抑酸组各项评分无明显差异，6个月时两组各项评分与健康对照组比较均无明显差异。

结论

声带任克水肿通过手术治疗效果显著，对伴有咽喉反流的患者术后给予抑酸治疗可加快嗓音恢复。

Abstract

Objective

To investigate the efficacy of microscopic laryngeal surgery

otherwise known as microlaryngoscopy

combined with gastric acid inhibition in the treatment of Reinke's edema.

Methods

The clinical data of 47 Reinke's edema patients with pharynx reflux preoperatively in our department from April 2016 to December 2019 were collected and retrospectively analyzed. These patient

s were divided into 2 subgroups according to receiving gastric acid inhibition (

=27) or not (

=20). At the same period

56 normal subjects (control group) were selected for examination and investigation. The changes of voice function and voice handicap index (VHI) score were compared and analyzed before and in 1

3 and 6 months after surgery.

Results

Before operation

fundamental frequency (F0) was significantly lower

and fundamental frequency perturbation (jitter)

noise/harmonic ratio (NHR) and amplitude perturbation (shimmer) were obviously higher in the patient group than the normal group (

0.05). At 3 and 6 months after operation

F0 was notably higher

while the levels of jitter

shimmer and NHR were remarkably lower in the acid inhibition subgroup than the non-acid inhibition subgroup

and significant differences were observed in above indicators between the former subgroup and the control group (

0.05). In 1

3 and 6 months after operation

F0 was gradually increased and the other 3 voice acoustic indicators were decreased at a certain degree in the both subgroups

with hoarseness gradually reduced. In 1 month after operation

there were no statistical differences in above indicators between the 2 subgroups

but F0 was higher while NHR

jitter and shimmer were lower in the acid inhibition subgroup than the non-acid inhibition subgroup at 3 and 6 months (

0.05)

though great differences were observed among the 2 subgroups and normal control. The scores of VHI in the patient group before operation were higher than those in the control group (

0.05). The patient group had significantly higher scores and total scores in VHI than the control group (

0.05). After operation

these scores were decreased gradually after operation

and there were no significant differences between the 2 subgroups at each time point. At 6 months

there w

as no significant difference among the 2 subgroups and the normal group.

Conclusion

Surgical treatment is very effective for Reinke's edema

and postoperative gastric acid inhibition therapy can accelerate voice recovery in the patients with pharynx and laryngeal reflux.

关键词

Keywords

references

TAVALUC R, HERMAN H, LIN J, et al . Does reinke's edema grade determine premalignant potential? [J ] . Ann Otol Rhinol Laryngol, 2018, 127(11): 812-816. DOI:10.1177/0003489418796529.

YONEKAWA H. A clinical study of Reinke's edema[J]. Auris Nasus Larynx, 1988, 15(1): 57-78. DOI:10.1016/s0385-8146(88)80010-5.

李进让, 肖水芳, 李湘平, 等. 咽喉反流性疾病诊断与治疗专家共识(2015年)解读[J]. 中华耳鼻咽喉头颈外科杂志, 2016, 51(5): 327-332. DOI:10.3760/cma.j.issn.1673-0860.2016.05.003.

LI J R, XIAO S F, LI X P, et al . Explanation of the experts consensus on diagnosis and treatment of laryngopharyngeal reflux disease (2015)[J ] . Chin J Otorhinolaryngol Head Neck Surg, 2016, 51(5): 327-332. DOI:10.3760/cma.j.issn.1673-0860.2016.05.003.

杨莉, 干强, 杨贵军, 等. 女性声带息肉术后发声功能恢复的时间观察[J]. 第三军医大学学报, 2016, 38(24): 2625-2628. DOI:10.16016/j.1000-5404.201607029.

YANG L, GAN Q, YANG G J, et al . Recovery time of phonation function in female patients after vocal polyp surgery[J ] . J Third Mil Med Univ, 2016, 38(24): 2625-2628. DOI:10.16016/j.1000-5404.201607029.

SEIFPANAHI S, JALAIE S , NIKOO M R, et al . Translated versions of voice handicap index (VHI)-30 across languages: a systematic review[J ] . Iran J Public Health, 2015, 44(4): 458-469.

URA-SABAT K, MORAWSKA J, DOMKA W, et al . The assessment of phonatory and ventilatory functions in patients after microsurgery for Reinke's edema[J ] . Adv Clin Exp Med, 2020, 29(7): 865-871. DOI:10.17219/acem/116755.

HAMDAN A L, KHALIFEE E, ABI AKL P R, et al . Pathogenic role of reinke's edema in snoring and obstructive sleep apnea[J ] . J Voice, 2020, 34(3): 456-459. DOI:10.1016/j.jvoice.2018.12.001.

WATANABE T, KANEKO K, SAKAGUCHI K, et al . Vocal-fold vibration of patients with Reinke's edema observed using high-speed digital imaging[J ] . Auris Nasus Larynx, 2016, 43(6): 654-657. DOI:10.1016/j.anl.2016.02.007.

TAVALUC R, TAN-GELLER M. Reinke's edema[J]. Otolaryngol Clin North Am, 2019, 52(4): 627-635. DOI:10.1016/j.otc.2019.03.006.

LIANG F Y, CHEN R H, LIN P L, et al . Correction to: Two-handed tying technique in vocal fold mucosa microsuture for the treatment of Reinke's edema[J ] . Eur Ar ch Otorhinolaryngol, 2019, 276(7): 2023. DOI:10.1007/s00405-019-05504-7.

SHIBA Y, MIZOJIRI G, NOZAKI T. Vocal function in Reinke's edema: degree of the lesion and indication of the operation[J]. Nihon Jibiinkoka Gakkai Kaiho, 1992, 95(9): 1345-1351. DOI:10.3950/jibiinkoka.95.1345.

李丹凤, 石力, 岳波, 等. 双侧声带任克氏间隙水肿个体化分级治疗的临床分析[J]. 临床医学研究与实践, 2020, 5(6): 3-4, 9. DOI:10.19347/j.cnki.2096-1413.202006002.

LI D F, SHI L, YUE B, et al . Clinical analysis of individualized grading therapy for bilateral vocal cord Reinke's edema[J ] . Clin Res Pract, 2020, 5(6): 3-4, 9. DOI:10.19347/j.cnki.2096-1413.202006002.

LECHIEN J R, SAUSSEZ S, NACCI A, et al . Association between laryngopharyngeal reflux and benign vocal folds lesions: a systematic review[J ] . Laryngoscope, 2019, 129(9): E329-E341. DOI:10.1002/lary.27932.

LECHIEN J R, HAMDAN A L, SAUSSEZ S. Laryngopharyngeal reflux and benign lesions of the vocal folds[J]. Eur Arch Otorhinolaryngol, 2019, 276(1): 277-278. DOI:10.1007/s00405-018-5217-8.

KANTAS I, BALATSOURAS D G, KAMARGIANIS N, et al . The influence of laryngopharyngeal reflux in the healing of laryngeal trauma[J ] . Eur Arch Otorhinolaryngol, 2009, 266(2): 253-259. DOI:10.1007/s00405-008-0744-3.

MARTINS R H G, TAVARES E L M, PESSIN A B B. Are vocal alterations caused by smoking in reinke's edema in women entirely reversible after microsurgery and smoking cessation?[J]. J Voice, 2017, 31(3): 380.e11-380.380.e14. DOI:10.1016/j.jvoice.2016.06.012.

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