鼻内镜手术、鼻内镜联合柯-陆氏进路和鼻侧切术治疗鼻腔鼻窦内翻性乳头状瘤的疗效对比观察

The Effects of Endoscopic Sinus Surgery,Nasal Endoscopy and Ke Lu's Approach and Nasal Resection to Nasal Inverted Papilloma

目的研究三种手术方式治疗鼻腔鼻宾内翻性乳头状瘤疗效。方法选择2008年3月至2013年1月我院收治的109例鼻腔鼻窦内翻性乳头状瘤患者进行研究。按照随机数表法，随机分为3组，分别采用鼻内镜手术、鼻内镜联合柯-陆氏进路和鼻侧切术三种手术方式对患者进行治疗，每组分别为41例、35例33例。结果术后，发现鼻内镜联合柯-陆氏进路组中Ⅲ级患者的术后肿瘤复发率（14．3％）明显低于鼻内镜组（22．2％），两组比较有统计学意义（P〈0．05）；鼻内镜组中II级、Ⅲ级患者的术后肿瘤复发率（1015％、22．2％）明显低于鼻侧切术组（27．8％，28．6％），两组比较有统计学意义（P〈0．05）。术后，发现三组患者的术后并发症发生情况有显著性差异（p〈0．05），鼻内镜纽中II级患者的术后并发症发生率（10．5％）明显低于鼻侧切术组患者（22．2％），两纽比较有统计学意义（p〈0．05）。鼻内镜联合柯-陆氏进路纽中II级患者的术后并发症发生率（10．5％）明显低于鼻侧切术组患者（22．2％），两组此较有统计学意义（P〈0．05）。鼻内镜纽中III级患者的术后并发症发生率（11．1％）明显低于鼻内镜联合柯．陆氏进路组（14．3％），两组比较有统计学意义（P〈0．05）。结论鼻内镜手术在III级鼻腔鼻窦内翻性乳头状瘤患者的治疗中，效果良好。对于III级鼻腔鼻赛内翻性乳头状瘤的患者进行治疗，鼻内镜联合柯-陆氏进路效果良好。

Objective To study the efficacy of three surgical treatment of nasal inverted papilloma. Methods 180 cases of sinonasal inverted papilloma patients from March 2009 to March 2012 were studied. They were randomly divided into three groups, each group had 60 patients.They were used endoscopic sinus surgery, nasal endoscopy and Ke Lu＇s approach and nasal resection of three surgical methods to treat patients. Results Postoperative nasal endoscopy and Ke Lu＇s approach the group of patients with stage III tumor recurrence rate （14.3%） was significantly lower than the the nasal endoscopy group （22.2%）, the two groups were statistically significant （P〈0.05）; nasal endoscopy group class II, class III patients with postoperative tumor recurrence rate （10.5%, 22.2%） was significantly lower than the nasal resection group （27.8%, 28.6%）, the two groups was statistically significant （P〈0.05）. After three groups of patients with postoperative complications significant difference （P〈0.05）, nasal endoscopy group of patients with grade II incidence of postoperative complications （10.5%） was significantly lower than the nasal resection group patients （22.2%）, the two groups was statistically significant （P〈0.05）. Nasal endoscopy and Ke Lu＇s approach group II level in patients with postoperative complication rate （10.5%） was signifieanfly lower than the nasal reseetion patients （22.2%）, the two groups was statistically significant （P〈0.05）. The nasal endoscopic group class UI patients with postoperative complication rate （11.1%） was significantly lower than the nasal endoscopy Ke Lu＇s approach group （14.3%）, the two groups was statistically significant （P〈0.05）.Conclusion Endoscopic sinus surgery I to level II sinonasal inverted papilloma in the treatment of patients with good results. Treatment for patients with level III sinonasal inverted papilloma,the nasal endoscopy Ke Lu＇s into the road has good effect.