介入栓塞术在鼻腔及鼻窦血管瘤治疗中的应用效果

Application effect of interventional embolization in the treatment of nasal cavity and paranasal sinus hemangioma

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摘要目的探讨介入栓塞术在鼻腔及鼻窦血管瘤治疗中的应用效果。方法选取2018年1月至2021年12月泰州市人民医院收治的84例鼻腔及鼻窦血管瘤患者,采用随机数字表法将其分为观察组(采取介入栓塞术治疗)和对照组(采取鼻内镜切除术治疗),每组42例。比较两组患者的手术指标,包括手术时间、住院时间、术中出血量及住院费用;比较两组患者术前、术后3 d的炎性因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平,鼻腔功能指标[鼻气道阻力、鼻腔最小横截面积至前鼻孔的距离(DCAN)、鼻腔容积(NCV)、鼻腔最小横截面积(NMCA)],嗅觉功能、黏膜形态及围手术期并发症发生情况。结果观察组患者的手术时间、住院时间、术中出血量、住院费用均少于对照组患者(P<0.05)。术后3 d,观察组患者的IL-6、IL-8、CRP、TNF-α水平均低于对照组患者,鼻气道阻力、DCAN均低于对照组患者,NCV、NMCA均高于对照组患者,T&T标准试嗅法评分、Lund-Kenndy评分均低于对照组患者(P<0.05)。两组患者围手术期出血、坏死、囊样息肉变、头痛及面部胀痛的发生率比较,差异均无统计意义(P>0.05)。结论介入栓塞术对鼻腔及鼻窦血管瘤患者的手术创伤较小,能够降低炎性因子水平,改善患者的鼻腔及嗅觉功能,未增加术后并发症,值得临床推广应用。 Objective To investigate the application effect of interventional embolization in the treatment of nasal cavity and paranasal sinus hemangioma.Method A total of 84 cases patients of nasal cavity and paranasal sinus hemangioma in Taizhou People’s Hospital from January 2018 to December 2021 were selected and divided into observation group and control group with 42 cases in each group by random number table.The control group was treated with endoscopic nasal resection,and the observation group was treated with interventional embolization.The surgical indexes including operation time,hospital stay,intraoperative blood loss and hospitalization cost were compared between the two groups;the inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],nasal function[the nasal airway resistance,the distance of minimal cross-sectional area to the nostril(DCAN),nasal cavity volume(NCV),nasal minimum cross-sectional area(NMCA)],olfactory function,mucosal morphology before and 3 days after operation and the perioperative complications were compared between the two groups.Result The operation time,hospital stay,intraoperative blood loss and hospitalization cost in the observation group were lower than those in the control group(P<0.05);3 days after surgery,IL-6,IL-8,CRP and TNF-αlevels were lower than those in the control group,the nasal airway resistance and the DCAN were lower than those in the control group,the NCV and NMCA were higher than those in the control group,the T&T standard olfactory score and LundKenndy score of the observation group were lower than those in the control group(P<0.05);there was no statistical significance in the incidence of bleeding,necrosis,cystoid polyps,headache and facial pain in the perioperative period of the two groups(P>0.05).Conclusion Interventional embolization for patients with nasal cavity and paranasal sinus hemangioma has less surgical trauma,can reduce the level of inflammatory factors,improve the nasal and olfactory function without increase of postoperative complications,which is worthy of application.

作者赵小军庞秀红王菲郭青戴翔 Zhao Xiaojun;Pang Xiuhong;Wang Fei;Guo Qing;Dai Xiang(Department of ENT and HN Surgery,Taizhou People's Hospital,Taizhou 225300,Jiangsu,China;Department of Vascular Surgery,Taizhou People's Hospital,Taizhou 225300,Jiangsu,China)

机构地区泰州市人民医院耳鼻咽喉头颈外科泰州市人民医院血管外科

出处《血管与腔内血管外科杂志》 2022年第9期1114-1119,共6页 Journal of Vascular and Endovascular Surgery

关键词介入栓塞术鼻腔及鼻窦血管瘤炎性因子鼻腔功能嗅觉功能鼻内镜切除术 interventional embolization nasal and paranasal hemangioma inflammatory factor nasal function olfactory function endoscopic nasal resection

分类号 R543 [医药卫生—心血管疾病]

作者简介赵小军,副主任医师,主要从事临床耳鼻咽喉头颈外科方向的研究,泰州市人民医院;通信作者:戴翔,主任医师,E-mail:dxtz066@163.com。