CO2 激光联合等离子射频消融术对早期声门型喉癌 相关细胞因子水平的影响

The effects of surgery of CO2 laser combined with plasma radiofrequency ablation on cytokines levels in patients with early glottic cancer

摘要:

目的 观察二氧化碳CO2 激光联合等离子射频消融术（PRA）治疗早期声门型喉癌患者前后血 管内皮生长因子（VEGF）、一氧化氮NO 及肿瘤坏死因子α（TNF-α）水平变化和疗效。方法 选取早期 声门型喉癌患者298 例作为研究对象，随机分为观察组与对照组，每组149 例。对照组患者接受传统喉裂开 术；观察组患者接受CO2 激光联合PRA。采用酶联免疫吸附法测定血清VEGF 及TNF-α，硝酸还原酶法 测定NO。分别收集两组患者术后恢复情况和1 年后并发症发生情况。结果 两组患者术前VEGF、NO 及 TNF-α 水平比较，差异无统计学意义（P >0.05）；而术后VEGF、NO 及TNF-α 水平比较，差异有统计学 意义（P <0.05）。观察组手术时间、住院时间低于对照组（P <0.05），黏膜恢复情况较对照组好；观察组并发 症发生率低于对照组（P <0.05）。结论 CO2 激光联合PRA 治疗早期声门型喉癌能有效减少手术创伤，改善 患者预后，降低患者血清VEGF、NO 及TNF-α 水平。

Abstract:

Objective To observe the changes of VEGF, NO and TNF-α in patients with early glottic cancer treated by CO2 laser combined with plasma radiofrequency ablation (PRA) and curative effect. Methods A total of 298 patients with early glottic cancer were selected as the subjects, which was divided into observation group (149 cases) and control group (149 cases) randomly. The control group were treated by laryngofissure, while the observation group were treated by CO2 laser combined with PRA. The serum levels of VEGF and TNF-α were measured by ELISA method, and NO was tested by nitrate reductase assay. The two groups were collected postoperative recovery and complications one year after surgeries. Results The difference was not statistically significant in preoperative levels of VEGF, NO and TNF-α between the two groups (P > 0.05). The difference was statistically significant in postoperative levels of VEGF, NO and TNF-α between the two groups (P < 0.05). The operation time and hospitalization time in observation group were shorter than those in control group (P < 0.05), and mucosa recovery in observation group was better than that in control group, and incidence of complication in observation group (6.04%) were lower than that in control group (16.78%) (P < 0.05). Conclusions Patients with early glottic cancer treated by CO2 laser combined with PRA can reduce surgical trauma, improve prognosis and effectively reduce serum levels of VEGF, NO and TNF-α.