上颌窦癌术后即刻修复与延期修复对比研究

Clinical study of immediate and delayed repair of maxillary sinus cancer

目的上颌窦癌是口腔颌面部的高发肿瘤,是发生于上颌窦的上皮源性恶性肿瘤。临床确诊的上颌窦癌多属中晚期,主要采取颌骨切除的手术方式配合即刻或延期修复降低术后组织缺损影响。本研究比较分析上颌窦癌手术后即刻修复与延期修复临床效果。方法选取1995-01-01-2015-12-30山东省肿瘤医院收治的153例上颌窦癌患者,均行上颌骨切除术并修复。153例中即刻修复73例,延期修复80例;上颌骨全切术45例,半侧或部分切除术108例。所有患者均随访2~5年,综合评价即刻修复与延期修复疗效,并进行统计分析。结果全切术组,即刻修复疗效好的占80.0%(12/15),延期修复疗效好的占56.7%(17/30);半侧或部分切除术组,即刻修复疗效好的占77.6%(45/58),延期修复疗效好的占54.0%(27/50)。检验结果表明,即刻修复比延期修复的疗效更占优势,OR=2.975,95%CI为1.447~6.120,P<0.05。结论上颌窦癌手术后即刻修复是行之有效的治疗方法,疗效满意。

OBJECTIVE To study immediate restoration and early functional construction in post-surgical treatment of maxillary sinus cancer,comparing with the efficacy of delayed repair restoration after maxillary sinus cancer operation, and to observe the advantages and disadvantages of these two repair methods considering with the patients~ satisfaction. METHODS Regular follow-up was conducted based on the data of 153 cases of patient who was operated maxillectomy and repair for maxillary sinus cancer from 1905 to 2015, among which 45 cases were total resection of maxillary bone, 108 cases were partial resection of maxillary bone. Totally 73 cases were immediate restoration,and 80 cases were delayed repair restoration. After two to five years of observation,the efficacy was evaluated. RESULTS In the group of maxillary total resection, 12 patients by immediate restoration were considered good（80.0 % ） while 17 patients（56.7 % ） by the oth- er way. In the partial or partial maxillotomy group,45 cases（77.6%） were immediate repair which had better curative effect, while 27 cases（54.0%） were delayed. The statistical test results showed that the immediate repair was more advan tageous than the delayed repair after controlling the effect of different surgical methods （OR = 2. 975,95 % CI： 1. 447- 6. 120,P〈0.05）. CONDLUSIONS Comparing the two methods, immediate restoration is an effective method for post- surgical treatment of maxillary sinus tumor with better patients＇ satisfaction. Postoperative delayed repair restoration has less effective,which also aggravates the psychological burden of patients.