摘要
目的分析鼻窦内翻性乳头状瘤（SNIP）鼻内镜手术的进路选择及与临床疗效的关系。方法收集116例经鼻内镜手术治疗SNIP患者的临床资料并进行分析,其中64例行单纯鼻内镜术（A组）,48例行鼻内镜联合改良柯陆术式手术（B组）,4例行鼻内镜联合鼻外进路术（C组）,对比分析3组患者的疗效。结果 3组患者均接受随访,随访时间为12~89个月,共14例（12.1%）患者复发,其中A组10例,B组3例,C组1例。总复发率A组（15.6%）显著高于B组（6.3%）,差异有统计学意义（P〈0.05）。病变定为Ⅲ级患者的复发率A组为53.8%（7/13）,B组为4.1%（1/24）,2组比较差异有极显著统计学意义（P〈0.01）。结论鼻内镜手术治疗SNIP疗效显著,大部分均可经单纯鼻内镜手术治愈,对于肿瘤累及额窦以及颌窦且病变广泛的Ⅲ~Ⅳ级患者,建议应用联合进路方式治疗,以减少手术盲区,从而减少肿瘤残留,有效降低复发率。
Objective To analyze the approach selection of nasal endoscopic surgery for sinonasal inverted papilloma （SNIP） and its relationship with clinical efficacy. Methods The clinical data of 116 cases with SNIP who had endoscopic surgery were analyzed, in which 64 cases had simple endoscopic surgery as group A ,48 cases had endoscopic surgery combined with modified Kelu technique as group B and 4 cases endoscopic surgery combined nasal approach as group C. The efficacy of the 3 groups were analyzed comparatively. Results The 3 groups of patients underwent follow-up for 12 - 89 months, and 14 patients （ 12.1% ）relapsed,including 10 patients in group A,3 cases in group B and 1 case in group C. The recurrence rate in group A （ 15.6% ） was significantly higher than that in group B （6.3 % ） （P 〈 0.05 ）. The recurrence rate of patients with path- ological changes of grade Ill was 53.8% （7/13） in group A and 4.1% （1/24）in group B,which had significant difference （ P 〈 0.01 ）. Conclusion Nasal endoscopic surgery for SNIP has significant effect and most of the patients are accessible to cure by a simple endoscopic surgery pathway. But for patients whose tumor involving the frontal and maxillary sinus lesions ex- tensively with grade III - IV, it is recommended application of combined approach means treatment to reduce the blind spot surgery, residual tumor, and reduce the relapse rate effectively.
出处
《新乡医学院学报》
CAS
2014年第5期378-380,共3页
Journal of Xinxiang Medical University
作者简介
徐继红（1965-），女，河南南阳人，本科，副主任医师，研究方向：耳鼻咽喉头颈外科学。
