目的:探讨利用窄带成像技术(narrow band imaging,NBI)术前术后辅助显微支撑喉镜下CO_(2)激光手术进行诊治的早期(T1和T2期)声门型喉癌的临床疗效。方法:回顾性分析2011年6月1日至2022年8月31日在天津市人民医院耳鼻咽喉头颈外科接受显微支撑喉镜下CO_(2)激光手术治疗的52例早期声门型喉癌患者资料,应用NBI辅助手术的27例患者为观察组,常规支撑喉镜下CO_(2)激光显微手术的25例患者为对照组,随访时间1~5年,总结分析2组患者术中冰冻病理结果、术后复发率、5年累积无复发生存率、并发症及嗓音恢复情况之间的差别。结果:52例患者均手术顺利,均无需行气管切开术,有1例患者出现声带粘连,但未出现呼吸困难及出血等严重并发症,并发症总发生率为1.92%。观察组5年累积无复发生存率为100%,对照组5年累积无复发生存率为77.90%,2组之间差异有统计学意义(P<0.05)。观察组较对照组的手术切缘更安全,更能准确判断肿瘤黏膜安全切缘(P<0.05)。所有患者进行了嗓音评估,嗓音障碍指数2组之间进行比较,差异无统计学意义(P>0.05)。结论:与常规支撑喉镜下CO_(2)激光显微手术比较,NBI辅助下显微支撑喉镜下CO_(2)激光手术切除早期声门型喉癌术后复发率低,并发症少,可有效提高5年无复发生存率,是一种更安全有效的治疗方法。
良性前列腺增生症(BPH)为中老年男性的多发病,手术治疗为最主要的治疗方式。随着科技的不断发展和激光在医学领域中的应用,可应用于前列腺手术方面的激光仪器主要为钬激光、半导体激光、蓝激光和绿激光等。由于这些激光其各自的特点不同,应用方式存在着差异。通过对各种激光的分析,结合文献阅读表明,激光微创技术将会给患者带来更多福音。随着激光技术在泌尿外科领域的广泛应用,其安全性、可靠性、有效性等优点将越来越多地得到泌尿外科医师的认可,甚至有取代传统TURP的可能。Benign prostatic hyperplasia (BPH) is a common disease in middle-aged and elderly men, and surgical treatment is the most important treatment method. With the continuous development of science and technology and the application of lasers in the medical field, the laser instruments that can be applied to prostate surgery are mainly holmium lasers, semiconductor lasers, blue lasers and green lasers. Due to the different characteristics of these lasers, there are differences in the way they are used. Through the analysis of various lasers, combined with literature reading, it is shown that laser minimally invasive technology will bring more benefits to patients. With the wide application of laser technology in the field of urology, its safety, reliability, effectiveness and other advantages will be recognized by more and more urologists, and even have the possibility of replacing traditional TURP.
