分析三种不同手术方法治疗鼻腔鼻窦内翻性乳头状瘤的效果

Analysis of effect with three different surgical treatment of nasal inverted papilloma

目的:探讨三种不同手术方法治疗鼻腔鼻窦内翻性乳头状瘤的效果。方法:选取66例NIP患者,对比分析鼻内镜手术如单纯中鼻道开窗,中、下鼻道开窗,中鼻道开窗加泪前隐窝入路等,鼻内镜下联合柯-陆手术,鼻内镜下鼻外入路手术三种手术方式的手术时间、出血量以及住院时间以及随访复发率。结果:三种手术方式、手术时间无明显差异(P>0.05);鼻外入路组出血量及住院时间均大于其余两组(P<0.05)。三组术后肿瘤复发率比较,差异无统计学意义(P>0.05);随着肿瘤分级的增加,复发率呈上升趋势。结论:对Ⅰ、Ⅱ级NIP的患者应提倡鼻内镜手术,Ⅲ级及病变范围较大患者应联合柯-陆氏手术或鼻腔外侧壁入路治疗效果好。

Objective To investigate the effect of three different surgical methods for treating nasal inverted papilloma. Method 66 ca- ses Nit＇ patients were selected,and implemented endoscopic sinus surgery such as the nasal passages wlndow,middle and inferior meatus window,middle meatus front windows and crypt approach ete, nasal endoscopy combined Ke - Lu surgery, and endoscopic nasN surger- y. Compare with the operative time, blood loss and length of hospital stay and follow - up recurrence rate of three surgical methods approach. Results The three surgical methods operative time had no significant difference （P 〉0. 05） ;The blood loss and length of hospital stay endoscopic of nasal group were higher than the other two groups （ P 〈 0. 05）. Three groups of tumor recurrence rate had no significant diffelenee（ P 〉 0.05 ） and with increasing tumor grade,the recurrence rate was rising, Conclusion Endoscopic surgery is benefit for grade Ⅰ and grade Ⅱ NIP patients,but grade Ⅲ lesions larger patients should be combined Ke - Good Luc surgery or endoscopic nasal surgery to get good effect.