鼻内镜在鼻腔鼻窦内翻性乳头状瘤切除术中的应用  

Clinical study of endoscopic surgical treatment for sinonasal inverted papilloma

作　　者：欧阳晖[1] 

机构地区：[1]四川省内江市第一人民医院耳鼻咽喉科,内江641000

出　　处：《中国肿瘤临床与康复》2014年第4期479-481,共3页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨鼻内镜在鼻腔鼻窦内翻性乳头状瘤(SNIP)切除手术中的作用及SNIP患者的最佳手术方式选择。方法回顾性分析手术治疗的207例SNIP患者的临床资料,按照不同手术方式分为传统手术组(95例)和鼻内镜手术组(112例),其中鼻内镜手术组患者按照是否联合鼻外入路又分为单纯鼻内镜手术组(52例)和鼻内镜联合鼻外入路组(60例)。所有患者手术后定期随访。结果传统手术组患者的肿瘤复发率为44.2%,鼻内镜手术组患者的肿瘤复发率为14.3%,其中单纯鼻内镜手术组患者的肿瘤复发率为23.1%,鼻内镜联合鼻外入路组患者的肿瘤复发率为6.7%。采用鼻内镜联合鼻外入路可缩短手术时间,鼻内镜手术组患者平均住院时间低于传统手术组患者。结论鼻内镜的介入使用能够降低手术切除SNIP的复发率,提高SNIP手术切除的治疗效果。借助鼻内镜的高分辨率优势,SNIP患者采用鼻内镜联合鼻外入路手术可取得更好的疗效,值得临床进一步推广使用。Objective To explore the value of endoscopic sinus in the management of sinonasal in- verted papilloma （SNIP）, and compare the differences of only endoscopic surgery, endoscopic surgery com- bined with an external approach and traditional procedures. Methods Two hundred and seven patients with SNIP form May 2010 to July 2012 were retrospectively reviewed. Among these patients, 95 cases were trea- ted by traditional surgical techniques, 112 cases were treated with endoscope, including 52 cases with only endoscopic surgery, 60 cases with endoscopic surgery combined with an external approach. All patients were followed up regularly. Results The inverted papilloma was removed completely by all kinds of techniques. The recurrence rate of traditional surgery group and endoscopic surgery was 44. 2% and 14. 3%, respective- ly. Meanwhile, the recurrence rate of only endoscopic surgery and endoscopic surgery combined with an ex- ternal approach was 23.1% and 6. 7%, respectively. The average operation time of the endoscopic surgery combined with an external approach was shorter than other type of surgery. Compared to the traditional sur- gery, the length of hospital stays of endoscopic surgery was also shorter. Conclusion The use of nasal en- doscope reduces the recurrence rate of SNIP and improves the clinical efficacy of surgical resection; mean- while, with the advantage of high resolution of endoscope, endoscopic surgery combined with an external ap- proach could achieve better efficacy for the management of patients with SNIP.

关 键 词：鼻腔 鼻窦 内翻性乳头状瘤 鼻内镜 手术 

分 类 号：R739.62[医药卫生—肿瘤]