鼻腔鼻窦内翻性乳头状瘤三种手术方式治疗的随机对照研究

易长龙

doi:10.13898/j.cnki.issn.1000-2200.2016.10.017

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鼻腔鼻窦内翻性乳头状瘤三种手术方式治疗的随机对照研究

易长龙

文章导航 > 蚌埠医学院学报 > 2016, 41 > 10: (1312-1315)

引用本文:

Citation:

鼻腔鼻窦内翻性乳头状瘤三种手术方式治疗的随机对照研究

易长龙

广东省珠海市高新区人民医院耳鼻喉科, 519085

作者简介: 易长龙(1971-),男,主治医师.

中图分类号: R739.6

Three operation methods in the treatment of nasal inverted papilloma: a randomized controlled study

YI Chang-long

Department of Otolaryngology, The High-tech People's Hospital of Zhuhai, Zhuhai Guangdong 519085, China
CLC number: R739.6

摘要: 目的：分析鼻内镜手术、鼻侧切手术及鼻内镜联合柯-陆手术治疗鼻腔鼻窦内翻性乳头状瘤（NIP）的临床疗效，比较3种手术的适用范围。方法：将141例NIP患者采用随机平行对照研究的方式，分为鼻内镜组、鼻侧切组及鼻内镜联合柯-陆手术组，分析3种手术的疗效，并随访并发症及复发率。结果：鼻内镜组、鼻侧切组及鼻内镜联合柯-陆手术组患者的手术时间、术中出血量及术后住院时间差异均有统计学意义（P<0.01）；随访1年内，鼻内镜组5例患者失访，鼻侧切组7例失访，鼻内镜联合柯-陆手术组3例失访；3组患者不同Krouse分期下的Ⅰ型、Ⅱ型、Ⅳ型总的复发率差异均无统计学意义（P>0.05）；鼻内镜联合柯-陆手术组Krouse Ⅲ型患者的复发率与鼻内镜组及鼻侧切组差异有统计学意义（P<0.05）；3组患者不同Krouse分期下的Ⅰ型、Ⅱ型、Ⅳ型并发症发生率及总并发症发生率差异均无统计学差异（P>0.05）；鼻内镜组及鼻侧切组患者的Krouse分期下Ⅲ型患者并发症发生率均高于鼻内镜联合柯-陆手术组（P<0.05）。结论：鼻内镜手术治疗NIP患者具有手术时间短、出血量少及住院时间短等优势，对于Krouse分期Ⅰ~Ⅱ期的患者更适合；对于Krouse分期Ⅲ期的患者采用鼻内镜联合柯-陆手术可显著减少手术并发症及复发率，对Krouse分期Ⅳ期的患者上述3种手术疗效均不理想。
- 鼻腔鼻窦内翻性乳头状瘤 /
- 鼻内镜 /
- 鼻侧切 /
- 鼻内镜联合柯-陆手术
Abstract: Objective: To compare the clinical effects between endoscopic sinus surgery,nasal incision and endoscopic Caldwell-Luc surgery in the treatment of nasal inverted papilloma(NIP),and explore the application of three kinds of operations.Methods: One hundred and forty-one NIP patients were randomly divided into the endoscopic sinus surgery group,nasal incision group and endoscopic Caldwell-Luc surgery group using randomized parallel controlled study way.The clinical effects,complications and recurrence rate between the three kinds of operations were analyzed.Results: The differences of the operation time,blood loss and postoperative hospitalization time between three groups were statistically significant(P>0.01).During the following up period,5 cases in endoscopic sinus surgery group,7 cases in nasal incision group and 3 cases in endoscopic Caldwell-Luc surgery group lost to follow.The differences of the total recurrence rate,incidence of complication and total complications in type Ⅰ,Ⅱ and Ⅳ Krouse between three groups were not statistically significant(P>0.05).The differences of the recurrence rates in patients with type Ⅳ Krouse between three groups were statistically significant(P<0.05).The incidences of complication in patients with type Ⅳ Krouse in endoscopic sinus surgery group and nasal incision group were higher than that in endoscopic Caldwell-Luc surgery group(P<0.05).Conclusions: The endoscopic sinus surgery in the treatment of nasal inverted papilloma is short operation time,little bleeding and short hospital stay,which is more suitable for the patients with type Ⅰ to Ⅱ Krouse.The treatment of type Ⅲ Krouse with endoscopic Caldwell-Luc surgery can significantly reduce complications and recurrence rate,the effects of type Ⅳ Krouse patients treated with three kinds operation are not ideal.
- nasal inverted papilloma /
- endoscopic sinus /
- nasal incision /
- endoscopic Caldwell-Luc surgery

[1]	张罗,韩德民,张盛忠,等.鼻腔鼻窦内翻性乳头状瘤[J].中国耳鼻咽喉头颈外科,2008,15(10):599.
[2]	王欢,余宏.鼻内翻性乳头状瘤恶变相关因素的研究[J].中国临床新医学,2009,2(2):208.
[3]	王向东,伯铭羽,徐景利,等.鼻内翻性乳头状瘤内镜手术治疗[J].中国耳鼻咽喉头颈外科,2013,20(5):251.
[4]	古庆家,何丕,邹胜琴,等.鼻内翻性乳头状瘤手术术式的选择与疗效[J].中国耳鼻咽喉颅底外科杂志,2010,16(6):429.
[5]	N'GATTIA KV,KACOUCHIA NB,MOBIO NM,et al.Sinonasal inverted papilloma:our experiences of diagnostic and surgical care in Côte d'Ivoire[J].Rev Med Brux,2014,35(1):4.
[6]	陆纪强,徐增瑞.鼻内翻性乳头状瘤的临床分级及术式选择研究进展[J].临床耳鼻咽喉头颈外科杂志,2013,27(14):797.
[7]	温海涛,丁岩,关荣春,等.鼻内镜下等离子手术治疗35例鼻腔内翻性乳头状瘤疗效分析[J].中国医药导刊,2014,16(4):588.
[8]	LIAN F,JUAN H.Different endoscopic strategies in the management of recurrent sinonasal inverted papilloma[J].J Craniofac Surg,2012,23(1):e44.
[9]	PAGELLA F,PUSATERI A,GIOURGOS G,et al.Evolution in the treatment of sinonasal inverted papilloma:pedicle-oriented endoscopic surgery[J].Am J Rhinol Allergy,2014,28(1):75.
[10]	BUSQUETS JM,HWANG PH.Endoscopic resection of sinonasal inverted papilloma:a meta-analysis[J].Otolaryngol Head Neck Surg,2006,134(3):476.
[11]	栾卫红,金光裕,单钜潮.不同手术方式治疗鼻腔鼻窦内翻性乳头状瘤的疗效比较[J].现代中西医结合杂志,2014,23(3):265.

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鼻腔鼻窦内翻性乳头状瘤三种手术方式治疗的随机对照研究

易长龙

作者简介: 易长龙(1971-),男,主治医师.

广东省珠海市高新区人民医院耳鼻喉科, 519085

收稿日期: 2014-10-07

关键词:

摘要: 目的：分析鼻内镜手术、鼻侧切手术及鼻内镜联合柯-陆手术治疗鼻腔鼻窦内翻性乳头状瘤（NIP）的临床疗效，比较3种手术的适用范围。方法：将141例NIP患者采用随机平行对照研究的方式，分为鼻内镜组、鼻侧切组及鼻内镜联合柯-陆手术组，分析3种手术的疗效，并随访并发症及复发率。结果：鼻内镜组、鼻侧切组及鼻内镜联合柯-陆手术组患者的手术时间、术中出血量及术后住院时间差异均有统计学意义（P<0.01）；随访1年内，鼻内镜组5例患者失访，鼻侧切组7例失访，鼻内镜联合柯-陆手术组3例失访；3组患者不同Krouse分期下的Ⅰ型、Ⅱ型、Ⅳ型总的复发率差异均无统计学意义（P>0.05）；鼻内镜联合柯-陆手术组Krouse Ⅲ型患者的复发率与鼻内镜组及鼻侧切组差异有统计学意义（P<0.05）；3组患者不同Krouse分期下的Ⅰ型、Ⅱ型、Ⅳ型并发症发生率及总并发症发生率差异均无统计学差异（P>0.05）；鼻内镜组及鼻侧切组患者的Krouse分期下Ⅲ型患者并发症发生率均高于鼻内镜联合柯-陆手术组（P<0.05）。结论：鼻内镜手术治疗NIP患者具有手术时间短、出血量少及住院时间短等优势，对于Krouse分期Ⅰ~Ⅱ期的患者更适合；对于Krouse分期Ⅲ期的患者采用鼻内镜联合柯-陆手术可显著减少手术并发症及复发率，对Krouse分期Ⅳ期的患者上述3种手术疗效均不理想。

English Abstract

Three operation methods in the treatment of nasal inverted papilloma: a randomized controlled study

YI Chang-long

Department of Otolaryngology, The High-tech People's Hospital of Zhuhai, Zhuhai Guangdong 519085, China

Received Date: 2014-10-07

Abstract: Objective: To compare the clinical effects between endoscopic sinus surgery,nasal incision and endoscopic Caldwell-Luc surgery in the treatment of nasal inverted papilloma(NIP),and explore the application of three kinds of operations.Methods: One hundred and forty-one NIP patients were randomly divided into the endoscopic sinus surgery group,nasal incision group and endoscopic Caldwell-Luc surgery group using randomized parallel controlled study way.The clinical effects,complications and recurrence rate between the three kinds of operations were analyzed.Results: The differences of the operation time,blood loss and postoperative hospitalization time between three groups were statistically significant(P>0.01).During the following up period,5 cases in endoscopic sinus surgery group,7 cases in nasal incision group and 3 cases in endoscopic Caldwell-Luc surgery group lost to follow.The differences of the total recurrence rate,incidence of complication and total complications in type Ⅰ,Ⅱ and Ⅳ Krouse between three groups were not statistically significant(P>0.05).The differences of the recurrence rates in patients with type Ⅳ Krouse between three groups were statistically significant(P<0.05).The incidences of complication in patients with type Ⅳ Krouse in endoscopic sinus surgery group and nasal incision group were higher than that in endoscopic Caldwell-Luc surgery group(P<0.05).Conclusions: The endoscopic sinus surgery in the treatment of nasal inverted papilloma is short operation time,little bleeding and short hospital stay,which is more suitable for the patients with type Ⅰ to Ⅱ Krouse.The treatment of type Ⅲ Krouse with endoscopic Caldwell-Luc surgery can significantly reduce complications and recurrence rate,the effects of type Ⅳ Krouse patients treated with three kinds operation are not ideal.