常规切除术和低温等离子消融术治疗上颌窦鳞状细胞癌侵犯鼻翼腭窝的效果

Effect of routine resection and hypothermic plasma ablation on patients with squamous cell carcinoma of maxillary sinus invading nasal alar and palatal fossa

目的探讨常规切除术和低温等离子消融术治疗上颌窦鳞状细胞癌侵犯鼻翼腭窝的效果。方法选取医院2015年1月至2017年6月收治的上颌窦鳞状细胞癌侵犯鼻翼腭窝患者78例,以随机数字表法分为对照组和观察组,各39例。对照组和观察组患者分别采用内镜下切除术和低温等离子消融术进行治疗。比较两组患者手术相关临床指标、手术前、后炎性细胞因子水平、术后并发症及随访复发率。结果观察组患者手术相关临床指标均显著优于对照组(P<0.05)。术后3 d,两组患者炎症因子指标水平均显著升高,但观察组显著低于对照组(P<0.05)。观察组患者术后并发症总发生率显著低于对照组(P<0.05)。两组患者术后1年复发率比较,差异不显著(P>0.05)。观察组患者术后3年复发率显著低于对照组(P<0.05)。结论内镜下低温等离子消融术用于上颌窦鳞状细胞癌侵犯鼻翼腭窝治疗能够有效缩短操作时间,加快患者术后康复进程,促进创面愈合,抑制炎症反应,降低术后并发症发生风险,并有助于预防癌症远期复发,临床应用价值优于内镜下切除术。

Objective To investigate the effect of routine resection and hypothermic plasma ablation on patients with squamous cell carcinoma of maxillary sinus invading nasal alar and palatal fossa.Methods A total of78patients with squamous cell carcinoma of maxillary sinus admitted in the hospital from January2015to June2017were divided into control group and observation group by random number table method,with39cases in each group.The control group and the observation group was treated with endoscopic resection and hypothermic plasma ablation respectively.The surgical related clinical indicators,the levels of preoperative and postoperative inflammatory cytokine,postoperative complications and follow-up recurrence rates between the two groups were compared.Results The surgical related clinical indicators in the observation group were significantly better than those in the control group(P<0.05).At3d after surgery,the levels of inflammatory factors in the two groups significantly increased,and those of the observation group were significantly lower than the control group(P<0.05).The total incidence of postoperative complications in the observation group was significantly lower than that in the control group(P<0.05).The recurrence rates at1year after surgery was not significantly different between the two groups(P>0.05),the recurrence rate at3years after surgery of the observation group was significantly lower than that of the control group(P<0.05).Conclusion Endoscopic hypothermic plasma ablation on patients with squamous cell carcinoma of maxillary sinus invading nasal alar and palatal fossa can effectively shorten the operation time,speed up the postoperative recovery process,promote wound healing,inhibit the inflammatory response,and decrease the risk of postoperative complications.It also helps to prevent the risk of long-term cancer recurrence,and its clinical application value is better than endoscopic resection.