三种不同方案治疗老年鼻腔鼻窦内翻性乳头状瘤的临床分析

Clinical Analysis of Three Different Treatment Schemes for the Treatment of Inverted Papilloma of Nasal Cavity and Paranasal Sinuses in the Elderly

目的探究3种不同方案治疗老年鼻腔鼻窦内翻性乳头状瘤的效果及安全性,为治疗该病提供方法参考。方法回顾性分析2017年1月到2019年2月于本院治疗的老年鼻腔鼻窦内翻性乳头状瘤患者90例的临床资料,根据不同治疗方案将90例患者分为3组:甲组、乙组和丙组,每组30例。甲组患者采用鼻内镜下手术治疗,乙组患者采用鼻侧切开手术治疗,丙组患者采用鼻内镜下手术联合柯路进路治疗。评估并比较3组患者的临床指标、复发情况以及并发症的发生情况。结果乙组患者的术中出血量、手术时间以及住院时间明显多于甲组和丙组(P<0.001);丙组患者的术中出血量、手术时间以及住院时间明显多于甲组(P<0.001)。随着Krouse分期的增加,患者的复发率增加,其中Ⅲ期和Ⅳ期的复发率明显高于Ⅰ期和Ⅱ期的复发率(P<0.05)。乙组患者的并发症发生率明显高于甲组和丙组(P<0.05);甲组和丙组患者的并发症发生率差异无统计学意义(P>0.05)。结论采用鼻内镜手术对老年鼻腔鼻窦内翻性乳头状瘤患者进行治疗,可减少术中出血,手术时间和住院时间短;采用鼻内镜下手术联合柯路进路治疗老年鼻腔鼻窦内翻性乳头状瘤,可减少复发和并发症发生率。

Objective To explore the efficacy and safety of three different regimens for the treatment of inverted papilloma of nasal cavity and paranasal sinuses in the Elderly.Methods The clinical data of 90 elderly patients with inverted papilloma of nasal cavity and paranasal sinuses treated in our hospital from January 2017 to February 2019 were analyzed retrospectively.According to different treatment schemes,they were divided into three groups,30 cases in each group.Group A were treated by endoscopic surgery,group B were treated by lateral rhinotomy,and group C were treated by endoscopic surgery combined with Kohl’s approach.The clinical indicators,recurrence and complications of three groups were compared one another.Results The intraoperative blood loss,operation time and length of hospital stay in group B were significantly higher than those in other two groups(P<0.001);The intraoperative blood loss,operation time,and length of hospital stay of patients in group C were significantly higher than those in group A(P<0.001).With the increase of Krouse stage,the recurrence rate of patients increased,and the recurrence rate of stage III and stage IV was significantly higher than that of stage I and stage II.The incidence of complications in group B was significantly higher than those in other two groups(P<0.05);there was no significant difference in the incidence of complications between group A and group C(P>0.05).Conclusion Endoscopic surgery for inverted papilloma of the nasal cavity and paranasal sinuses in the elderly can reduce intraoperative bleeding,shorten the operation time and hospital stay;Endoscopic surgery combined with Kohl’s approach can reduce the recurrence and the incidence of complications of inverted papilloma of the nasal cavity and paranasal sinuses in the elderly.