经鼻镜手术治疗累及鼻颅底区域鼻腔鼻窦骨源性良性肿瘤的效果观察

Effect of endoscopic sinus surgery on sinonasal benign osteogenic tumors with involvement of nasal skull base region

目的探讨经鼻镜手术治疗累及鼻颅底区域鼻腔鼻窦骨源性良性肿瘤的效果。方法抽取2017年1月至2020年1月平顶山市第二人民医院收治的鼻腔鼻窦骨源性良性肿瘤患者98例,按照治疗方式分为内镜组与传统组,每组49例。内镜组给予鼻镜联合柯-陆手术,传统组采用传统鼻侧切开手术。观察比较两组治疗效果、并发症发生情况及复发率。结果内镜组与传统组患者均成功进行手术切除肿瘤并治愈出院,经病理学检查均无恶性肿瘤患者。内镜组手术时间、术中出血量、住院时分别为(30.5±6.7)min、(64.7±14.6)ml、(6.4±2.7)d,均少于传统组的(48.7±10.5)min、(108.4±23.8)ml、(9.8±3.6)d,P均<0.05。内镜组并发症发生率为6.12%(3/49),复发率为2.04%(1/49),均低于传统组的22.45%(11/49)、14.29%(7/49),P均<0.05。结论在鼻腔鼻窦骨源性肿瘤的治疗中,鼻镜治疗相对于传统开鼻手术具有对患者损伤小、并发症与复发率低等优势。

Objective To investigate the effect of endoscopic sinus surgery in the treatment of sinonasal benign osteogenic tumors with involvement of nasal skull base region.Methods A total of 98 patients with sinonasal benign osteogenic tumors treated in the Second People’s Hospital of Pingdingshan from January 2017 to January 2020 were included.According to treatment methods,they were divided into endoscopic group and traditional group,with 49 cases in each group.Patients in endoscopic group were treated by nasal endoscopy and Caldwell-Luc surgery,and patients in traditional group were treated by traditional lateral rhinotomy.The therapeutic effect,complications and recurrence rate of the two groups were observed and compared.Results The patients in endoscopic group and traditional group successfully underwent operation,and they were discharged from hospital.There was no malignant case according to results of pathological examination.The operation time,intraoperative blood loss,and hospitalization time in endoscopic group were(30.5±6.7)min,(64.7±14.6)ml,and(6.4±2.7)d,respectively,which were lower than the(48.7±10.5)min,(108.4±23.8)ml,and(9.8±3.6)d,respectively,in traditional group(all P<0.05).The complication rate and recurrence rate of endoscopic group were 6.12%(3/49)and 2.04%(1/49),lower than the 22.45%(11/49)and 14.29%(7/49)of traditional group(all P<0.05).Conclusions Compared with the traditional lateral rhinotomy,nasal endoscopic treatment of sinonasal benign osteogenic tumors with involvement of nasal skull base region has advantages of small injury,low rate of complications and recurrence.