鼻内镜下切除术与唇龈沟路径切除术治疗鼻前庭囊肿的临床研究  

A Clinical Study on Nasal Endoscopic Resection and Labial Gingival Sulcus Resection in Treatment of Patients with Nasal Vestibular Cyst

作　　者：朱姝 王平 李科婷 谢卓君 ZHU Shu;WANG Ping;LI Ke-ting;XIE Zhuo-jun(Department of Otolaryngology,the 416 Nuclear Industry Hospital,the Second Affiliated Hospital of Chengdu Medical College,Chengdu 610000,China)

机构地区：[1]成都医学院第二附属医院核工业四一六医院耳鼻咽喉科,成都610000

出　　处：《解放军医药杂志》2021年第7期100-104,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：2017年四川省卫生和计划生育委员会科研课题(16PJ431)。

摘　　要：目的对比分析鼻内镜下切除术与唇龈沟路径切除术对鼻前庭囊肿患者手术效果、炎症反应、免疫功能、凝血功能的影响。方法选取2016年3月—2019年3月我院收治的行手术治疗的鼻前庭囊肿85例,其中观察组43例行鼻内镜下切除术,对照组42例行唇龈沟路径切除术,比较2组手术情况、炎性因子、免疫功能指标、凝血功能指标水平,并记录2组术后并发症发生情况及术后1年疾病复发情况。结果与对照组比较,观察组手术时间、术后住院时间明显缩短,术中出血量明显减少,术后视觉模拟评分法评分明显降低,差异有统计学意义(P<0.01)。术后2组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和C反应蛋白(CRP)水平均升高,且观察组血清TNF-α、IL-6和CRP水平显著低于对照组,差异有统计学意义(P<0.05,P<0.01)。术后2组CD3+、CD4+/CD8+和NK细胞水平均降低,且观察组CD3+、CD4+/CD8+和NK细胞水平高于对照组,差异有统计学意义(P<0.05,P<0.01)。术后观察组凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、国际标准化比值显著低于对照组,纤维蛋白原高于对照组,差异有统计学意义(P<0.01)。与对照组比较,观察组术后并发症总发生率明显降低(P<0.01)。术后随访1年,2组均无复发。结论与唇龈沟路径切除术相比,鼻内镜下切除术治疗鼻前庭囊肿具有手术时间短、术中出血少、创伤小、术后并发症少、术后恢复快等优势,且可有效减轻患者术后炎症反应及对患者免疫功能、凝血功能的影响。Objective To compare and analyze effects of nasal endoscopic resection and labial gingival sulcus resection on surgical effectiveness,inflammatory reaction,immune function and coagulation function in treatment of patients with nasal vestibular cyst(NVC).Methods A total of 85 patients with NVC admitted between March 2016 and March 2019 were selected and divided into observation group(n=43,treated with NVC resection under nasal endoscope)and control group(n=42,treated with NVC resection via labial gingival sulcus approach).Operative conditions,inflammatory factors,immune function indexes and coagulation function indexes were compared,and incidence rates of postoperative complications and conditions of disease recurrence after operation for 1 year were recorded in two groups.Results Compared with those in control group,values of operative duration,postoperative hospital stay,intraoperative volume of blood loss and postoperative pain score of visual analogue scale(VAS)were significantly lower in observation group(P<0.01).After operation,levels of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and C-reactive protein(CRP)were significantly increased in two groups,but levels of the above indexes in observation group were significantly lower than those in control group(P<0.05,P<0.01).After operation,levels of CD3+,CD4+/CD8+and NK cells were significantly decreased compared with those before operation in two groups,but levels of the above indexes in observation group were significantly higher than those in control group(P<0.05,P<0.01).After operation,in observation group,values of prothrombin time,activated partial thromboplastin time,thrombin time and international standardized ratio were significantly lower than those in control group,while fibrinogen level was significantly higher than that in control group(P<0.01).The total incidence rate of postoperative complications in observation group was significantly lower than that in control group(P<0.01).After 1-year of follow-up,there was no recurrence in two gro

关 键 词：囊肿 鼻疾病 囊肿切除术 鼻内镜切除术 肿瘤坏死因子-α CD3+ 凝血酶原时间 手术后并发症 

分 类 号：R765.2[医药卫生—耳鼻咽喉科]