不同鼻内镜手术对鼻内翻性乳头状瘤的治疗效果  

Therapeutic effect of different endoscopic sinus surgery on nasal inverted papilloma

作　　者：赖琛[1] 郑曼丽 杨国炳 郑彬[2] LAI Chen;ZHENG Man-li;YANG Guo-bing;et al(Otolaryngology Head and Neck surgery, China People＇ s Armed Police Corps in Zhejiang Province Hospital of Hangzhou, Hangzhou, Zhejiang 310051, China)

机构地区：[1]中国人民武装警察部队浙江省总队杭州医院耳鼻咽喉头颈外科,浙江杭州310051 [2]浙江省人民医院耳鼻咽喉科,浙江杭州310003

出　　处：《中华全科医学》2018年第2期222-225,共4页Chinese Journal of General Practice

基　　金：2015年浙江省医药卫生一般研究计划项目(2015-KYB025)

摘　　要：目的探讨单纯性鼻内镜手术、鼻内镜+柯-陆氏手术、鼻内镜下经泪前隐窝入路手术3种术式对鼻内翻性乳头状瘤的治疗效果。方法选择2011年1月—2015年12月中国人民武装警察部队浙江省总队杭州医院收治的鼻内翻性乳头状瘤行单纯鼻内镜手术者80例作为鼻内镜手术组,鼻内镜+柯-陆氏手术者80例作为鼻内镜+柯-陆氏手术组,鼻内镜下经泪前隐窝入路手术者80例作为经泪前隐窝入路手术组。收集3组患者的术中出血量、手术时间、住院时间、术后复发情况、术后并发症等资料。结果鼻内镜+柯-陆氏手术组和鼻内镜下经泪前隐窝入路手术组术中出血量、手术时间、住院时间均高于鼻内镜手术组(P<0.05)。鼻内镜手术组、鼻内镜+柯-陆氏手术组、鼻内镜下经泪前隐窝入路手术组Ⅰ期、Ⅱ期鼻内翻性乳头状瘤的术后复发率比较差异均无统计学意义(均P>0.05),传统鼻内镜手术组Ⅲ期鼻内翻性乳头状瘤术后复发率高于鼻内镜+柯-陆氏手术组和鼻内镜下经泪前隐窝入路手术组(P<0.05),鼻内镜+柯-陆氏手术组Ⅲ期鼻内翻性乳头状瘤术后复发率低于鼻内镜下经泪前隐窝入路组,但差异无统计学意义(P>0.05)。鼻内镜手术组、鼻内镜+柯-陆氏手术组、鼻内镜下经泪前隐窝入路手术组鼻内翻性乳头状瘤患者术后并发症均为0例,3组Ⅱ期和Ⅲ期鼻内翻性乳头状瘤患者术后并发症发生率比较差异均无统计学意义(均P>0.05)。结论单纯鼻内镜手术治疗Ⅰ期和Ⅱ期鼻内翻性乳头状瘤术中出血少、手术时间和住院时间短,但治疗Ⅲ期鼻内翻性乳头状瘤术后复发率高,Ⅲ期鼻内翻性乳头状瘤患者适合采用鼻内镜+柯-陆氏手术及鼻内镜下经泪前隐窝入路手术。Objective To explore the treatment of nasal inverted papilloma by simple endoscopic sinus surgery, nasal endos- copy ＋ Ke-Lu surgery and nasal endoscopic transnasal approach. Methods In this study, 80 patients with nasal inverted pap- illoma underwent endoscopic sinus surgery were selected as the endoscopic surgery group, 80 patients with nasal endoscopy ＋ Ke-Lu surgery were treated as nasal endoscopy ＋ Ke-Lu surgery group, and 80 patients with nasal endoscopic transnasal ap- proach were selected as nasal endoscopic transnasal approach group in our hospital from January, 2011 to December, 2015. The intraoperative blood loss, operation time, hospitalization time, postoperative recurrence and postoperative complications were collected of the three groups. Results The intraoperative blood loss, operation time and hospital stay of nasal endoscopy ＋ Ke- Lu surgery group and nasal endoscopic transnasal approach group were higher than that in endoscopic surgery group （P 〈 0.05）. There were no significant difference in the recurrence rate of stage I and stage Ⅱ nasal inverted papilloma among endo- scopic sinus surgery, nasal endoscopy ＋ Ke-Lu surgery group and nasal endoscopic transnasal approach group （P 〉0.05）. The recurrence rate of stage Ⅲ nasal inverted papilloma in endoscopic sinus surgery group was higher than that of nasal endoscopy ＋ Ke-Lu surgery group and nasal endoscopic transnasal approach group（P 〈 0.05 ）. The recurrence rate of stage Ⅲ nasal inverted papilloma of nasal endoscopy ＋ Ke-Lu surgery group was lower than that of the nasal endoscopic transnasal ap- proach group, but the difference was not statistically significant （P 〉 0.05）. The nasal inverted papilloma after surgery of nasal endoscopic surgery group, nasal endoscopy ＋ Ke-Lu surgery group and nasal endoscopic transnasal approach group stage I pa- tients were all 0 cases. There were no significant difference in the incidence of postoperative complications of stage Ⅱ and stage m patients among the th

关 键 词：鼻内镜手术 鼻内翻性乳头状瘤 鼻内镜+柯-陆氏手术 鼻内镜下经泪前隐窝入路 

分 类 号：R739.62[医药卫生—肿瘤] R765.9[医药卫生—临床医学]