鼻内镜下泪前隐窝入路术式及柯陆入路术式治疗对上颌窦内翻性乳头状瘤患者机体应激指标的影响与安全性研究  

The Effect and Safety of Nasal Endoscopic Anterior Tear Crypt Approach and Kolu Approach Treatment on Organic Stress Indicators in Patients with Maxillary Sinus Inverting Papilloma

作　　者：刘景林 黄员福[1] 薛梅[1] LIU Jinglin;HUANG Yuanfu;XUE Mei(Department of Otorhinolaryngology,Head and Neck Surgery,Sanming Second Hospital,Sanming,Fujian Province,366000 China)

机构地区：[1]三明市第二医院耳鼻咽喉头颈外科,福建三明366000

出　　处：《中外医疗》2024年第15期13-16,共4页China & Foreign Medical Treatment

摘　　要：目的 探讨鼻内镜下泪前隐窝入路术式及柯陆入路术式治疗对上颌窦内翻性乳头状瘤(Inverting Papilloma, IP)患者机体应激指标的影响与安全性。方法 前瞻性随机选取2019年4月—2023年8月三明市第二医院确诊为上颌窦IP的120例患者为研究对象,按照随机数表法分为两组,每组60例,对照组行鼻内镜下柯陆入路术式处理,观察组行鼻内镜下泪前隐窝入路术式治疗,比较两组的手术基础指标、不同手术阶段的机体应激指标、术后并发症及复发情况。结果 观察组手术时间、术中出血量、术后鼻通气时间、住院时间均优于对照组,差异有统计学意义(P均<0.05)。术后1 d,观察组肾上腺素、皮质醇、转化生长因子β1检测值均低于对照组,差异有统计学意义(P均<0.05)。观察组术后并发症总发生率(3.33%)低于对照组(13.33%),差异有统计学意义(χ^(2)=3.927,P=0.047)。两组术后半年的复发率比较,差异无统计学意义(P>0.05)。结论 鼻内镜下泪前隐窝入路术式、柯陆入路术式用于上颌窦IP患者的治疗远期疗效相当,但前者还具有近期处理效果较好,可减轻机体应激反应,减少并发症发生等优势。Objective To investigate the effects and safety of nasal endoscopic anterior tear crypt approach and Kolu approach treatment on the organism stress indexes of patients with maxillary sinus inverting papilloma(IP).Methods 120 patients diagnosed with maxillary sinus IP in Sanming Second Hospital from April 2019 to August 2023 were pro⁃spective randomly selected as the study objects,and were divided into two groups of 60 cases each according to the method of randomized number table.The control group was treated with nasal endoscopic Kolu approach,and the ob⁃servation group was treated with nasal endoscopic anterior tear crypt approach.Comparison of the two groups'surgical base indexes,organism stress indexes in different surgical stages,postoperative complications and recurrence.Results The operation time,intraoperative bleeding,postoperative nasal ventilation time,and hospitalization time of the obser⁃vation group were better than those of the control group,and the differences were statistically significant(all P<0.05).At 1 d postoperatively,the detection values of epinephrine,cortisol and transforming growth factorβ1 in the observa⁃tion group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The total incidence of postoperative complications in the observation group(3.33%)was lower than that in the control group (13.33%), and the difference was statistically significant (χ^(2)=3.927, P=0.047). There was no statistically significant difference in the recurrence rate six months after surgery between the two groups (P>0.05). Conclusion Nasal endoscopic anterior tear crypt approach and Kolu approach are used for the treatment of patients with maxillary sinus IP with comparable long-term efficacy, but the former also has the advantages of better near-term management, can reduce the body's stress response, and reduce the occurrence of complications.

关 键 词：上颌窦内翻性乳头状瘤 鼻内镜 泪前隐窝入路 柯陆入路 

分 类 号：R5[医药卫生—内科学]