改良内窥镜下上颌骨内侧切除术治疗鼻窦内翻性乳头状瘤患者的疗效

The Curative Effect of Modified Endoscopic Medial Maxillary Resection on Patients with Inverted Papilloma of Nasal Sinus

目的 探讨改良内窥镜下上颌骨内侧切除术治疗鼻窦内翻性乳头状瘤(NIP患者的疗效。方法 选取2015年1月至2020年12月医院收治的60例NIP患者作为研究对象,采用随机数字表法分为对照组和试验组,各30例。对照组采用鼻内镜下中鼻道联合鼻腔外侧壁切开术,试验组采用改良内窥镜下上颌骨内侧切除术治疗,比较两组围手术期指标、血清炎性因子水平[肿瘤坏死因子-α(TNF-α),白细胞介素-2(IL-2),白细胞介素-6(IL-6)]、治疗效果、并发症发生率及复发情况。结果 试验组术中出血量明显少于对照组,手术时间短于对照组,差异有统计学意义(P<0.05);两组住院时间、创面愈合时间比较,差异无统计学意义(P>0.05);术后,两组IL-6、TNF-α水平均高于术前,两组IL-2水平均低于术前,差异有统计学意义(P<0.05),两组IL-6、TNF-α、IL-2水平比较,差异无统计学意义(P> 0.05);试验组治疗总有效率与对照组比较,差异无统计学意义(P> 0.05);试验组并发症发生率与对照组比较,差异无统计学意义(P> 0.05);术后1年,试验组出现1例复发,对照组出现3例复发,差异无统计学意义(P>0.05)。结论 改良内窥镜下上颌骨内侧切除术治疗NIP可有效改善患者围术期指标,具有较好的临床疗效,且不增加炎症反应、并发症发生率与复发率,安全性较高。

Objective The curative effect of modified endoscopic medial maxillary resection on patients with inverted papilloma of the nasal sinus(NIP)was investigated.Methods With selection of 60 NIP patients admitted to the hospital from January 2015 to December 2020 as the study subjects,they were divided into control group and experimental group by random number table method,with 30 patients in each group.With the use of endoscopic middle nasal meatus combined with lateral nasal wall incision in the control group,and the use of modified endoscopic medial maxillary resection in the experimental group,perioperative indexes,serum inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-2(IL-2),interleukin-6(IL-6)],therapeutic efficacy,complication rate,and recurrence were compared between the two groups.Results The intraoperative blood loss of the experimental group was significantly less than that of the control group,and the operation time was shorter than that of the control group,and the differences were statistically significant(P<0.05);There was no significant difference in hospital stay and wound healing time between the two groups(P>0.05);After operation,the levels of IL-6 and TNF-αin the two groups were higher than those before operation,and the level of IL-2 in the two groups was lower than that before operation,and the difference was statistically significant(P<0.05).There was no significant difference in the levels of IL-6,TNF-α,and IL-2 between the two groups(P>0.05).There was no significant difference in the total effective rate between the experimental group and the control group(P>0.05);There was no significant difference in the incidence of complications between the experimental group and the control group (P> 0.05);One year after operation, there was 1 case of recurrence in the experimentalgroup and 3 cases in the control group, and the difference was not statistically significant(P > 0.05). Conclusion Modified endoscopic medial maxillectomy for NIP can effectivelyimprove the perioperative indexes of patients with better clinical efficacy, and it does not increasethe incidence of inflammatory reaction, complications and recurrence rate, with high safety.