经鼻内镜下手术治疗侵及眼眶的鼻腔鼻窦恶性肿瘤的临床分析  

Clinical analysis of transnasal endoscopic surgery on malignant neoplasms of nasal cavity and sinuses invading orbit

作　　者：王俊 陈鹏飞 曹顺东 WANG Jun;CHEN Pengfei;CAO Shundong(Department of Otolaryngology,the First People's Hospital of Guangshui City,Suizhou,Hubei,432700,China;Department of Pharmacy,the First People's Hospital of Guangshui City,Hubei Province,Suizhou,Hubei,432700,China)

机构地区：[1]广水市第一人民医院耳鼻喉科,湖北随州432700 [2]广水市第一人民医院药剂科,湖北随州432700

出　　处：《当代医学》2023年第9期118-121,共4页Contemporary Medicine

摘　　要：目的探讨经鼻内镜下手术对侵及眼眶的鼻腔鼻窦恶性肿瘤的临床疗效及其预后效果。方法选取2013年5月至2015年5月本院收治的64例侵及眼眶的鼻腔鼻窦恶性肿瘤患者作为研究对象,追踪随访5年,统计患者的预后生存率和复发率,分析影响患者预后效果的因素。结果64例患者中,59例临床症状明显改善,总缓解率为92.19%;3例失访,随访完成率为95.31%(61/64)。随访5年,复发率为22.95%(14/61),6例转移,2例颅内转移,2例淋巴结转移,2例骨转移。5年总生存率为59.02%(36/61);Ⅰ、Ⅱ、Ⅲ期患者的中位生存期分别为61、22、15个月。不同临床分期的生存曲线比较差异有统计学意义(P<0.05);鳞状细胞癌、腺样囊性癌、肉瘤及其他恶性肿瘤整体中位生存期分别为20、35、10和50个月,各生存曲线比较差异无统计学意义;将临床分期纳入多因素进行回归方程分析,结果显示,临床分期Ⅲ期是影响患者预后的独立危险因素(P<0.05)。结论经鼻内镜下手术治疗侵及眼眶的鼻腔鼻窦恶性肿瘤疗效显著,对患者创伤小,有利于预后恢复,患者的预后效果与肿瘤的临床分期密切相关。Objective To investigate the clinical and prognostic effects of transnasal endoscopic surgery on malignant neoplasms of nasal cavity and sinuses invading orbit.Methods 64 patients with malignant neoplasms of nasal cavity and sinuses invading orbit admitted to our hospital from May 2013 to May 2015 were selected as the research subjects,followed up for 5 years,the prognostic survival rate and recurrence rate of the patients were count,and the factors affecting the prognostic effect of the patients were analyzed.Results Among 64 patients,59 patients significantly improved clinical symptoms,and the total remission rate was 92.19%;In 64 patients,3 patients were lost to follow-up,and the follow-up completion rate was 95.31%(61/64).At 5 years of follow-up,the recurrence rate was 22.95%(14/61),with 5 cases of metastases,2 cases of intracranial metastasis,2 cases of lymph node metastases,and 2 cases of bone metastases.The 5-year overall survival rate was 59.02%(36/61);the influence of different clinical stages on prognosis survival rate showed that the median survival of stageⅠ,ⅡandⅢstage patients was 61,22 and 15 months,respectively.The survival curves of different clinical stages were statistical significant(P<0.05);the overall median survival period of squamous cell carcinoma,adenoid cystic carcinoma,sarcoma and other malignant tumors were 20,35,10 and 50 months,respectively,and the difference in each survival curve was not statistical significant;clinical stage was included in multiple factors for regression equation analysis,the results showed that clinical stage was an independent risk factor affecting patient prognosis(P<0.05).Conclusion The nasal endoscopic treatment of malignant neoplasms of nasal cavity and sinuses is effective,with little trauma to patients and conducive to prognosis recovery,and the prognosis effect of patients is closely related to the clinical stage of the tumor.

关 键 词：经鼻内镜下手术 鼻腔鼻窦恶性肿瘤 侵及眼眶 临床疗效 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]