鼻内镜手术联合低温等离子射频消融术治疗鼻腔鼻窦内翻性乳头状瘤的临床疗效及生活质量评价

Clinical Efficacy and Quality of Life Evaluation of Endoscopic Sinus Surgery Combined with Low Temperature Plasma Radiofrequency Ablation in the Treatment of Sinonasal Inverted Papilloma

目的:分析鼻腔鼻窦内翻性乳头状瘤(sinonasal inverted papilloma, SNIP)经鼻内镜手术联合低温等离子射频消融术治疗的临床疗效及术后生活质量。方法:本研究设计为单中心回顾性研究,连续纳入2016年1月至2018年6月在我院接受单纯鼻内镜手术治疗的32例SNIP患者作为对照组,纳入2018年7月至2020年12月接受鼻内镜手术联合低温等离子射频消融术治疗的41例SNIP患者作为观察组,比较两组患者的手术相关指标(手术时间、术中出血量、住院时间、术后并发症等)、临床疗效,并随访其术后复发情况,采用鼻腔鼻窦结局测试22条量表(Sino-Nasal Outcome Test-22, SNOT-22)、疼痛视觉模拟评分量表(Visual Analogue Scale, VAS)对患者手术前后的生活质量进行评价。结果:观察组与对照组相比,术中出血量、住院时间均低于对照组,差异均有统计学意义(均P <0.05)。观察组的总有效率高于对照组(97.6%vs 84.4%),差异有统计学意义(χ^(2)=4.142, P=0.042)。观察组T3期患者术后1年复发率明显低于对照组患者,差异有统计学意义(P <0.05)。手术后观察组患者的SNOT-22和VAS评分均低于对照组,差异均有统计学意义(均P <0.05)。结论:鼻内镜手术联合低温等离子射频消融术治疗SNIP,临床疗效确切,具有术中出血量少、住院时间缩短、疼痛轻、复发率低、术后生活质量恢复快等优势,值得临床推广应用。

Objective : To analyze the clinical efficacy of endoscopic sinus surgery combined with low temperature plasma radiofrequency ablation(LTPRA) in the treatment of sinonasal inverted papilloma(SNIP), and the quality of life of the patients. Methods : In this single center retrospective study, 32 SNIP patients who underwent endoscopic surgery in our hospital from January 2016 to June 2018 were included as the control group, and 41 SNIP patients who underwent endoscopic surgery combined with LTPRA from July 2018 to December 2020 were included as the observation group. The operation indexes(operation time, intraoperative bleeding, length of stay,postoperative complications, etc.) and clinical efficacy of the two groups were compared, and the postoperative recurrence of patients was followed up. The quality of life of the patients before and after operation was evaluated with Sinonasal Outcome Test-22(SNOT-22) and Visual Analogue Scale(VAS). Results : The amount of intraoperative bleeding and length of stay in the observation group were significantly lower than those in the control group(all P < 0.05). The total clinical efficacy rate in the observation group was significantly higher than that in the control group(97.6% vs 84.4%, χ^(2) = 4.142, P = 0.042). After operation, the recurrence rate of T3 patients in the observation group was significantly lower than that in the control group(P < 0.05);the scores of SNOT-22 and VAS in the observation group were lower than those in the control group(all P < 0.05). Conclusion : Endoscopic sinus surgery combined with LTPRA is confirmed to be effective for SNIP. It has the advantages of less intraoperative bleeding, shorter length of stay, less pain, low recurrence rate and rapid recovery of postoperative quality of life, which is worthy of clinical application.