低温等离子射频消融术联合鼻内镜手术治疗鼻腔鼻窦内翻性乳头状瘤的效果观察

Observation of therapeutic effect of low-temperature plasma radiofrequency ablation combined with nasal endoscopic surgery on inverted papilloma of the nasal cavity and paranasal sinuses

目的观察低温等离子射频消融术联合鼻内镜手术治疗鼻腔鼻窦内翻性乳头状瘤的临床效果。方法抽取2021年5月至2022年6月驻马店市中心医院收治的101例鼻腔鼻窦内翻性乳头状瘤患者进行研究,按随机数字表法分为对照组(50例)和观察组(51例),对照组采取单纯鼻内镜手术治疗,观察组采取低温等离子射频消融术联合鼻内镜手术治疗,研究过程中观察组脱落2例,对照组未见脱落情况。比较两组临床疗效、手术基本情况(手术时间和出血量、住院时间)、术后并发症发生情况、术前及术后鼻腔鼻窦结局测试-20(SNOT-20)量表评分变化与Lund-kennedy鼻内镜评分变化;术后随访1年,观察两组复发率。结果观察组临床治疗总有效率(95.92%,47/49)优于对照组(84.00%,42/50),P<0.05。观察组手术时间长于对照组,但其住院时间短于对照组,出血量少于对照组(P<0.05)。观察组术后并发症发生率(4.08%,2/49)低于对照组(18.00%,9/50),P<0.05。术前,两组SNOT-20评分以及Lund-kennedy量表评分比较差异未见统计学意义(P>0.05);术后,两组SNOT-20评分以及Lund-kennedy量表评分均改善,且观察组SNOT-20评分以及Lund-kennedy量表评分均优于对照组(P均<0.05)。术后1年,观察组疾病复发率(0,0/49)低于对照组(10.00%,5/50),P<0.05。结论鼻腔鼻窦内翻性乳头状瘤患者采取低温等离子射频消融术联合鼻内镜手术治疗的效果较好,患者手术基本情况较好,并发症少,术后鼻窦功能及嗅觉功能恢复较好,术后1年疾病复发率低。

Objective To observe the clinical effect of low-temperature plasma radiofrequency ablation combined with nasal endoscopic surgery in the treatment of inverted papilloma of the nasal cavity and paranasal sinuses.Methods A total of 101 patients with inverted papilloma of the nasal cavity and sinuses admitted to Zhumadian Central Hospital from May 2021 to June 2022 were selected for the study.The patients were divided into control group(50 cases)and observation group(51 cases)by random number table method.The patients in the control group were treated by simple nasal endoscopic surgery.And patients in the observation group were treated by low-temperature plasma radiofrequency ablation combined with nasal endoscopic surgery.During the study,2 cases were lost to follow-up in the observation group,and no patient was lost to follow-up in the control group.Clinical efficacy,basic conditions of surgery(operation time and amount of blood loss,length of hospital stay),postoperative complications,changes in preoperative and postoperative sino-nasal outcome test-20(SNOT-20)score and Lund-kennedy scale score of nasal endoscopy of the two groups were compared.Patients of the two groups were followed up for 1 year after operation to observe the recurrence rate.Results The clinical therapeutic effect of the observation group(95.92%,47/49)was better than that of the control group(84.00%,42/50),P<0.05.Compared with the control group,the observation group had longer operation time,shorter hospital stay,shorter hospital stay and less blood loss(P<0.05).The incidence of postoperative complication of the observation group(4.08%,2/49)was lower than that of control group(18.00%,9/50),P<0.05.There was no significant difference in preoperative SNOT-20 score and Lund-kennedy scale score between the two groups before treatment(P>0.05);after treatment,the SNOT-20 score and Lund-kennedy scale score were improved in the two groups(P<0.05).The scores of SNOT-20 and Lund-kennedy scale in the observation group were better than those in the control group(all P<0.05).One year after surgery,the recurrence rate of the observation group(0,0/49)was lower than that of the control group(10.00%,5/50),P<0.05.Conclusions Low-temperature plasma radiofrequency ablation combined with nasal endoscopic surgery has a good therapeutic effect on patients with inverted papilloma of the nasal cavity and paranasal sinus,treated by which patients have good basic conditions and low complication rate.The postoperative sinus function and olfactory function of the patients have recovered well,and the 1-year postoperative recurrence rate of the disease is low.