内镜下低温等离子射频消融切除Krouse T2和T3期鼻内翻性乳头状瘤的临床疗效分析(附手术视频)  

Clinical effect analysis of low temperature plasma radiofrequency ablation of Krouse T2 and T3 nasal inverted papilloma under endoscope(with surgical video)

作　　者：张丙文[1] 孟玲韩 陈荣荣[1] 赵真 ZHANG Bingwen;MENG Linghan;CHEN Rongrong;ZHAO Zhen(Department of Otolaryngology Head and Neck Surgery,the Affiliated Nanjing Hospital of Nanjing Medical University(Nanjing First Hospital),Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)耳鼻咽喉-头颈外科,江苏南京210006

出　　处：《南京医科大学学报（自然科学版）》2024年第8期1069-1075,共7页Journal of Nanjing Medical University(Natural Sciences)

基　　金：南京市卫生科技发展专项(宁卫财务[2021]67号第20)。

摘　　要：目的:分析内镜下低温等离子切除Krouse T2和T3期鼻内翻性乳头状瘤(nasal inverted papilloma,NIP)的临床疗效。方法:回顾性分析南京医科大学附属南京医院(南京市第一医院)耳鼻咽喉-头颈外科于2012年10月—2022年10月收治并行内镜下手术的141例Krouse T2和T3期NIP患者的临床病例资料,并根据术中是否使用低温等离子射频消融切除肿瘤及处理肿瘤根基,分为使用低温等离子射频消融的观察组和不使用低温等离子射频消融的对照组。对比分析两组患者的手术时间、术中出血量、平均住院时间、术后疼痛视觉模拟评分(visual analogue scale,VAS)、术后并发症和术后复发率。结果:观察组T2+T3期和T3期NIP患者平均手术时间短于相应对照组,但差异无统计学意义(P>0.05);观察组T2期NIP患者平均手术时间短于相应对照组,差异有统计学意义(P<0.05)。与相应对照组比较,观察组T2+T3、T2及T3期NIP患者平均术中出血量更少,平均住院时间更短,术后疼痛VAS评分更低,差异有统计学意义(P<0.05)。观察组T2+T3、T2及T3期NIP患者的术后并发症发生情况与相应的对照组比较,差异无统计学意义(P>0.05)。观察组T2+T3和T3期NIP患者术后复发率低于对照组,差异有统计学意义(P<0.05),虽然观察组T2期患者术后NIP复发率低于对照组,但差异无统计学意义(P>0.05)。结论:内镜下低温等离子射频消融术可在清晰的手术视野下处理Krouse T2和T3期NIP及其基底,具有术中出血量少、住院时间短、疼痛轻、复发率低等优势,临床疗效满意,值得推广应用。Objective:To analyze the clinical efficacy of low temperature plasma radiofrequency ablation of Krouse T2 and T3 nasal inverted papilloma(NIP)under nasal endoscope.Methods:Clinical data of 141 cases with Krouse T2 and T3 NIP treated with endoscopic surgery at the Department of Otolaryngology Head and Neck Surgery,the Affiliated Nanjing Hospital of Nanjing Medical University(Nanjing First Hospital)from October 2012 to October 2022,were retrospectively analyzed,and the tumor was resected and treated with or wthout low temperature plasma radiofrequency ablation during the operation.They were divided into observation group using low temperature plasma radiofrequency ablation and control group without low temperature plasma radiofrequency ablation.The operative time,intraoperative blood loss,average length of hospital stay,postoperative visual analogue scale(VAS)score of pain,postoperative complications and postoperative recurrence rate were compared between the two groups.Results:The average operation time of NIP patients with T2+T3 and T3 stage in the observation group was less than that of the corresponding control group,but the difference was not statistically significan(t P>0.05);the average operation time of NIP patients with T2 stage in the observation group was less than that of the corresponding control group,and the difference was statistically significant(P<0.05).The average intraoperative blood loss,the average length of hospitalization,and postoperative pain VAS scores of patients with T2+T3,T2 and T3 stage in the observation group were lower than those in the corresponding control group,and the difference was statistically significant(P<0.05).There was no statistical significance in the postoperative complications of patients with T2+T3,T2 and T3 stage in the observation group compared with the corresponding control group(P>0.05).The postoperative recurrence rate of patients with T2+T3 and T3 stage in the observation group was lower than that of the control group,with statistical significance(P<0.05),whi

关 键 词：鼻内翻性乳头状瘤 鼻内镜 低温等离子射频消融 

分 类 号：R739.62[医药卫生—肿瘤]