鼻内镜下鼻腔鼻窦内翻性乳头状瘤切除的手术进路选择与疗效观察

Surgical Approach Selection and Curative Effect of Nasal Endoscopic Sinusectomy with Inverted Papilloma

目的:观察研究鼻内镜下鼻腔鼻窦内翻性乳头状瘤切除的手术进路选择与疗效。方法:选择鼻内镜手术治疗的鼻腔鼻窦内翻性乳头状瘤患者90例,对其中52例患者进行单纯的鼻内镜手术,为A组,对其中38例患者进行鼻内镜联合改良柯-陆术式手术,为B组。结果:A组Ⅰ级患者中有1例(5.88%)复发,Ⅱ级患者中有6例(31.58%)复发,Ⅲ级患者中有3例(18.75%)复发,总复发率为19.23%。B组19例Ⅱ级患者中有2例(10.53%)复发,Ⅲ级患者中有1例(5.26%)复发,总复发率为7.89%。两组Ⅲ级患者复发率比较,差异有统计学意义(P<0.05),Ⅰ级患者与Ⅱ级患者复发率比较,差异无统计学意义(P>0.05)。结论:鼻内镜手术治疗鼻腔鼻窦内翻性乳头状瘤效果良好,采用单纯鼻内镜进路术式能够完成大部分的手术,Ⅲ级患者采用鼻内镜联合改良柯-陆术式效果更好,复发率较低。

Objective：To observe the surgical approach and curative effect of the surgical approach to the removal of a papilloma of the nasal cavity in nasal endoscopic sinus.Method：90 cases with inverted papilloma of the nasal sinuses turn sexual for nasal endoscopic surgery were selected,including 52 patients with simple nasal endoscopic surgery as group A,38 patients with nasal endoscopy combined improved ke-land operation surgery as group B.Result：In group A,1 case（5.88%） was recurrence in level Ⅰ,6 cases（31.58%） in level Ⅱ,3 cases（18.75%） in level Ⅲ,overall recurrence rate was 19.23%.In group B,4 cases（21.05%） in level Ⅱ was recurrence,1 case（5.26%） in level Ⅲ,overall recurrence rate was 7.89%.Compared the recurrence of level Ⅲ between the two groups,the difference was statistically significant（P〈0.05）;there were no significant differences between the two groups for level Ⅱ and level Ⅰ.Conclusion：Nasal endoscopic surgery in the treatment of nasal sinus varus papilloma effect is good;using the simple approach of nasal endoscopic surgery can complete most of the surgery,level Ⅲ treated by nasal endoscopy combined improved ko-land operation is better,and the recurrence rate is low.