鼻内镜下低温等离子射频消融术在早期鼻腔鼻窦恶性肿瘤治疗中的应用

Application of low-temperature plasma radiofrequency ablation under nasal endoscope in the treatment of early nasal and paranasal sinus malignant tumors

目的探讨鼻内镜外科技术与低温等离子射频术相结合治疗早期鼻腔鼻窦恶性肿瘤的疗效。方法回顾性分析2015年1月~2016年1月收入我科手术治疗并完成1年随访的12例鼻腔鼻窦恶性肿瘤患者的临床资料。所有患者均在鼻内镜下行低温等离子射频消融手术,其中鳞状细胞癌8例,腺样囊性癌3例,髓外浆细胞瘤1例。记录手术时间、术中出血量,术后并发症以及术后1年随访情况。术后1月辅助放疗。结果术中出血量为20~150 ml,中位出血量为50 ml。手术用时40~90 min,中位时间为60 min。术后1个月门诊复查鼻内镜,术腔无肿瘤残留、上皮化较好,术后1年复查无复发。结论鼻内镜下低温等离子射频手术治疗早期鼻腔鼻窦恶性肿瘤,在切除肿瘤同时具有术中出血少、手术时间短、术后反应小、恢复较快、患者舒适性高等优势。

To explore the curative effect of low temperature plasma radiofrequency ablation in the treatment of early malignant tumors of nasal cavity and paranasal sinus under nasal endoscope.Methods 12 patients with malignant tumors of nasal cavity and paranasal sinus were treated and analyzed retrospectively from January 2015 to January 2016 and completed 1 year follow-up.All patients were underwent endoscopic radiofrequency ablation,including 8 cases of squamous cell carcinoma,3 cases of adenoid cystic carcinoma,and 1 case of extramedullary plasmacytoma.The operative time,intraoperative blood loss,postoperative complications,and recurrence at 1 year after surgery were recorded.Results The intraoperative blood loss was 20~150 ml,and the median blood loss was 50 ml.The operation time was 40~90 min,and the median time was 60 min.1 month after operation,the nasal endoscopy was reexamined in outpatient clinic.No residual tumors and epithelialization were found in the operative cavity,and no recurrence occurred in 1 year after operation.Conclusion Endoscopic application of low-temperature plasma radiofrequency surgery for nasal cavity and sinus cancer has the advantages of less bleeding,less damage,and shorter operative time.