鼻腔鼻窦内翻性乳头状瘤不同术式的疗效分析  

The Efficacy Analysis of Different Operative Methods in Sinonasal Inverted Papilloma

作　　者：申月玲[1] 赵晓峰[1] 马瑞霞[2] 

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学附属医院耳鼻咽喉头颈外科,银川750004

出　　处：《宁夏医科大学学报》2011年第1期38-41,共4页Journal of Ningxia Medical University

摘　　要：目的分析三种不同手术方法治疗鼻腔鼻窦内翻性乳头状瘤的效果，为正确选择手术方法提供依据。方法分析219例手术治疗的鼻腔鼻窦内翻性乳头状瘤病例资料。根据Krouse分级病变，Ⅰ级30例，Ⅱ级85例，Ⅲ级84例，Ⅳ级20例。其中采取鼻内镜手术102例（鼻内镜组），鼻内镜联合柯路氏进路93例（鼻内镜联合柯路氏进路组），鼻侧切术24例（鼻侧切组）。所有患者术后随访5个月～8年，平均3．5年。比较三种不同手术方式术后复发率、并发症发生率及术中出血量。结果①复发率：经鼻内镜手术者复发15例（14．7％）；经鼻内镜联合柯路氏手术者14例（15．1％）；经鼻侧切开手术者5例（23．5％）。其中Ⅲ级患者术后复发率鼻内镜手术组高于鼻内镜联合柯路氏组（P〈0．05）；Ⅱ级和Ⅳ级患者术后复发率鼻内镜手术组较鼻侧切开组低（P〈0．05）。②并发症发生率：不同术式术后并发症发生率有所不同（P〈0．05）。其中Ⅱ级患者术后复发率鼻内镜手术组低于鼻侧切开组（P〈0．05）；鼻内镜联合柯路氏组低于鼻侧切开组（P〈0．05）。Ⅲ级患者鼻内镜组术后并发症发生率低于鼻内镜联合柯路氏组（P〈0．05）。③术中出血量：鼻内镜组明显少于鼻侧切组（P〈0．05）。结论对Ⅰ～Ⅱ级鼻内翻性乳头状瘤的病变应积极提倡使用鼻内窥镜手术，对肿瘤涉及上颌窦的Ⅲ级病变，联合柯路氏手术疗效较好。Objective To evaluate the therapeutic effects of surgery on inverting papilloma in nasal cavity and paranasal sinus among three kinds of surgical procedures, So as to provide basis for the correcttly choosing operation method. Methods Clinical information of 219 patients with sinonasal inverted papiloma treated surgically were retrospectively reviewed. According to Krouse classification, There Were 30 cases in stage Ⅰ; 85 cases in stage Ⅱ; 84 cases in stage Ⅲ and 20 cases in stage Ⅳ. Among these patients, 102 cases were treated endoscopically （nasal endoscopic surgery group） ; 93 cases were treated by endoscopic excision combined with Caldwell - Luc procedure （ endoscopic excision combined with Caldwell - Luc surgery group） ; 24 cases underwent lateral rhinotomy （nasal lateral incision group）. All patients were followed up 5 months - 8 years （average 3.5 years）. Postoperative recurrence rate, complications and peri - operative bleeding of three kinds of surgeries were compared. Results Recurrence rate of Ⅲ stage patients was significantly higher in nasal endoscopic surgery group that that in endoscopic excision combined with Caldwell -Luc surgery group（P 〈0.05 ）. Recurrence rate of Ⅰ and Ⅳ stage patients was significantly lower in nasal endoscopic surgery group that that in nasal lateral incision group （P 〈 0.05 ）. Incidence of omplications showed significant difference among different surgeries （ P 〈 0.05 ）. Comparing nasal endoscopic surgery group and nasal lateral incision group, complication incidence of Ⅱ stage patients was significant difference （ P 〈 0.05 ） ; comparing endoscopic excision combined with Caldwell - Luc surgery group and nasal lateral incision group, complication incidence of Ⅱ stage patients was significant difference （P 〈 0.05 ） ; The volume of bleeding during surgery in nasal endoscopic surgery group was significantly lower than that in nasal lateral incision group （ P 〈 0.01 ）. Conclusion The nasal endoscopy was a bett

关 键 词：内翻性乳头状瘤 鼻内镜手术 鼻侧切术 

分 类 号：R739.62[医药卫生—肿瘤]