鼻内镜辅助下联合柯路氏入路手术治疗鼻内翻性乳头状瘤临床效果分析

Clinical Effect of Nasal Endoscope-Assisted Caldwell-Luc Surgery for Nasal Inverted Papilloma

目的:探讨鼻内镜辅助下联合柯路氏入路手术治疗鼻内翻性乳头状瘤(nasal inverted papilloma,NIP)的临床效果。方法:回顾性分析2010年1月至2019年3月我院收治的136例NIP患者的临床资料。根据手术适应证选择不同治疗方式,分为观察组(鼻内镜辅助下柯路氏手术)和对照组(单纯鼻内镜手术)。对于两组患者,手术时间术中出血量、住院时间、术后疼痛评分、术后睡眠质量、术后并发症和随访1年内复发率进行对比分析。结果:观察组与对照组相比,手术时长、术中失血量均超过对照组,差异有统计学意义(均P<0.05)。观察组与对照组VAS评分总体比较,差异无统计学意义(F_(组间)=1.713,P=0.196);术后不同时点观察组与对照组组内比较,存在时间效应(F_(组内)=13.295,P<0.001)。观察组与对照组PSQI评分总体平均水平比较,差异无统计学意义(F_(组间)=1.102,P=0.298);术后不同时点观察组与对照组组内比较,PSQI评分存在时间效应(F_(组内)=6.157,P<0.001)。两组患者的并发症总发生率,Ⅱ期、Ⅲ期患者的并发症发生率无统计学意义(P>0.05);观察组Krouse分期Ⅲ期的患者术后复发率低于对照组,差异有统计学意义(P<0.05)。结论:单纯鼻内镜下手术及鼻内镜辅助下柯路氏手术均能安全有效的治疗鼻内翻性乳头状瘤,对于Krouse分期为Ⅲ期的患者采用内镜辅助下柯路氏手术效果更佳。

Objective:To investigate the clinical effect of nasal endoscope-assisted Caldwell-Luc surgery in the treatment of nasal inverted papilloma(NIP).Methods:Clinical data of 136 patients with NIP admitted to our hospital from January 2010 to March 2019 were analyzed retrospectively,and were assigned to the observation group(nasal endoscope-assisted Caldwell-Luc surgery)and the control group(nasal endoscopic surgery),respectively.Operation time,intraoperative bleeding volume,length of stay,postoperative visual analogue scale(VAS)score,postoperative sleep quality,postoperative complications and recurrence rate within 1 year of follow-up werecompared between the two groups.Results:The averageoperation time in the observation group was significantly longer than that in the control group(P<0.05),and the intraoperative bleeding volume in the former was significantly higher thanthat in the latter(P<0.05).VAS scores were not significantly different between two groups(F_(group)=1.713,P=0.196),while VAS scores by time were significantly different(F_(time)=13.295,P<0.001);PSQI scores were not significantly differ-ent between two groups(F_(group)=1.102,P=0.298),while PSQI scores by time were significantly different(F_(time)=6.157,P<0.001).There were no statistically significant differences between the two groups in neither the incidence of complica-tions in Krouse stage Ⅱ and Ⅲ patients nor that in all patients(P>0.05);the recurrence rate in Krouse stage Ⅲ patientsin the observation group was significantly lower than that in the control group(P<0.05).Conclusion:lt is safe and effec-tive to treat NIP by either nasal endoscopic surgery alone or by nasal endoscope-assisted Caldwell-Luc surgery,and the latteris better for Krouse stage Ⅲ patients.