鼻内镜下上颌窦侧壁剥离术治疗鼻内翻性乳头状瘤的临床效果

Clinical effect of maxillary sinus lateral wall dissection under nasal endoscopy in the treatment of nasal inverted papilloma

目的探讨鼻内镜下上颌窦侧壁剥离术治疗鼻内翻性乳头状瘤的临床效果。方法鼻内翻性乳头状瘤患者86例采用随机数字表法将其分为两组,各43例。对照组给予传统鼻侧切开术,观察组给予鼻内镜下上颌窦侧壁剥离术,比较两组临床效果。结果观察组患者手术耗时、术中出血量、住院康复时间均优于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率为93.03%(40/43),复发率为2.33%(1/43),对照组患者分别为95.35%(41/43)、4.65%(2/43),差异均无统计学意义(χ^2=0.212、0.345,P=0.645、0.557);观察组术后并发症发生率为2.33%(1/43),对照组为18.60%(8/43),两组比较差异有统计学意义(χ^2=6.081,P=0.014)。治疗后,两组SIL-2R、PTN、IgE、TNF-α、IL-6比较,差异有统计学意义(P<0.05)。结论对鼻内翻性乳头状瘤患者,给予鼻内镜下鼻腔外侧壁切开上颌窦手术治疗具有创伤小、术后恢复快、复发率低,且风险较小等优点,值得推广应用。

Objective To investigate the clinical effect of maxillary sinus lateral wall dissection under nasal endoscopy in the treatment of nasal inverted papilloma.Methods 86 patients with nasal inverted papilloma were divided into two groups of 43 patients by random number table method.The control group was given conventional lateralrhinotomy,and the observation group was given maxillary sinus lateral wall dissection under nasal endoscopy.The clinical effects were compared between the two groups.Results Patients in the observation group were better than those in the control group in terms of surgery duration,intraoperative blood loss,and length of stay for rehabilitation.The differences were statistically significant(P<0.05).The total effective rate of the treatment in the observation group was 93.03%(40/43),and the recurrence rate was 2.33%(1/43).For those in the control group,the total effective rate was 95.35%(41/43),and the recurrence rate was 4.65%(2/43).The differences were not statistically significant(χ^2=0.212,0.345,P=0.645,0.557);the incidence rate of postoperative complications was 2.33%(1/43)in the observation group and 18.60%(8/43)in the control group.The difference between the two groups was statistically significant(χ^2=6.081,P=0.014).After treatment,there were statistically significant differences in SIL-2R,PTN,IgE,TNF-α,IL-6 between the two groups(P<0.05).Conclusion For patients with nasal inverted papilloma,nasal endoscopic maxillary sinus lateral wall dissection has the advantages of less trauma,rapid postoperative recovery,low recurrence rate,and lower risk,which is worthy of popularization and application.