鼻腔鼻窦乳头状瘤鼻内镜手术的进路选择与疗效比较

Comparison of the therapeutic effect of nasal endoscopic surgery in the treatment of nasal and nasal endoscopic surgery

目的:观察鼻腔鼻窦乳头状瘤(SNIP)鼻内镜手术的进路选择与疗效。方法:选取进行鼻内镜治疗的45例SNIP患者的临床资料作为研究对象,鼻内镜组27,作为联合组18例。所有患者全麻后行鼻乳头状瘤摘除术,鼻内镜组行单纯鼻内镜手术,联合组行鼻内镜联合改良柯陆术式术,观察两组患者复发率。结果:鼻内镜组Ⅰ级、Ⅱ级、Ⅲ级患者术后复发率分别为9.09%、6.64%、3.64%,总复发率为44.44%;联合组Ⅰ级、Ⅱ级、Ⅲ级患者术后复发率分别为0.00%、11.11%、11.11%,总复发率为11.11%。I级、II级患者复发率两组无明显差异(P>0.05),Ⅲ级及总复发率鼻内镜组明显高于联合组,且具有统计学差异(P<0.05)。结论:鼻内镜手术对于SNIP患者疗效显著,Ⅰ级患者行单纯鼻内镜手术即可,Ⅱ级患者根据病变累及部位选择手术进路,Ⅲ级患者采用联合进路效果更佳。

Objective To investigate the selection and efficacy of nasal endoscopic surgery in the treatment of nasal and nasal papilloma（ SNIP）. Method The clinical data of 45 patients with SNIP was selected as the study subjects,27 cases in the nasal endoscopic group and 18 cases in the combined group. In all patients after general anesthesia,nasal papilloma was removed,nasal endoscopic group was treated with simple nasal endoscopic surgery,combined with endoscopic sinus surgery combined with modified surgical procedure. The recurrence rate of the two groups were observed. Results Endoscopic group Ⅰ level,Ⅱ level,Ⅲ level in patients with postoperative recurrence rate were 9. 09%,6. 64%,3. 64%,respectively,the total recurrence rate was44. 44%;the combined group Ⅰ,Ⅱ level and Ⅲ level in patients with postoperative recurrence rate were 0. 00%,11. 11%,11. 11%,the total recurrence rate was 11. 11%. Patients with grade Ⅰ and grade Ⅱ recurrence rate had no significant difference between the two groups（ P 〉0. 05）,grade Ⅲ and total recurrence rate in the endoscopic group were significantly higher than those in the combined group,and the difference was statistically significant（ P 〈0. 05）. Conclusion Nasal endoscopic surgery for SNIP patients with significant curative effect,Ⅰ grade patients with simple nasal endoscopic surgery can be,Ⅱ grade patients according to the lesions involved in the selection of surgical approach,Ⅲ patients with a combined approach is better.