CAJ | 학술논문

目的：分析采用影像导航进行鼻内翻性乳头状瘤、鼻窦骨瘤鼻内镜手术与传统鼻内镜手术的疗效。方法73例鼻腔内翻性乳头状瘤、鼻窦骨瘤患者被分成导航组与非导航组，导航组采用影像导航下鼻内镜手术，非导航组采用传统鼻内镜手术。分析两组患者的手术时间、麻醉时间、术中出血量、并发症及术后疗效情况。结果导航组与非导航组患者麻醉时间比较，差异无统计学意义（P＞0．05），手术时间、术中出血量比较，差异有统计学意义（P＜0．05）。鼻腔内翻性乳头状瘤导航组与非导航组Ⅰ、Ⅱ级复发率比较，差异无统计学意义（P＞0．05），而在Ⅲ、Ⅳ级中复发率比较，差异有统计学意义（P＜0．05）。鼻窦骨瘤中非导航组有1例复发，导航组未见复发病例。鼻腔内翻性乳头状瘤中导航组与非导航组鼻内并发症比较，差异有统计学意义（P＜0．05），Ⅰ、Ⅱ级鼻内并发症导航组与非导航组的发生率比较，差异无统计学意义（P＞0．05），而在Ⅲ、Ⅳ级鼻内并发症的发生率比较，差异有统计学意义（P＜0．05）。在鼻窦骨瘤中导航组与非导航组鼻内并发症比较，差异有统计学意义（P＜0．05）。结论对于鼻窦骨瘤及Ⅲ、Ⅳ级鼻腔内翻性乳头状瘤，影像导航下鼻内镜手术优于传统鼻内镜手术，特别在术前评价和确保手术中的安全性方面起到了有价值的辅助作用，使得肿瘤切除更彻底，复发率更低。
목적：분석채용영상도항진행비내번성유두상류、비두골류비내경수술여전통비내경수술적료효。방법73례비강내번성유두상류、비두골류환자피분성도항조여비도항조，도항조채용영상도항하비내경수술，비도항조채용전통비내경수술。분석량조환자적수술시간、마취시간、술중출혈량、병발증급술후료효정황。결과도항조여비도항조환자마취시간비교，차이무통계학의의（P＞0．05），수술시간、술중출혈량비교，차이유통계학의의（P＜0．05）。비강내번성유두상류도항조여비도항조Ⅰ、Ⅱ급복발솔비교，차이무통계학의의（P＞0．05），이재Ⅲ、Ⅳ급중복발솔비교，차이유통계학의의（P＜0．05）。비두골류중비도항조유1례복발，도항조미견복발병례。비강내번성유두상류중도항조여비도항조비내병발증비교，차이유통계학의의（P＜0．05），Ⅰ、Ⅱ급비내병발증도항조여비도항조적발생솔비교，차이무통계학의의（P＞0．05），이재Ⅲ、Ⅳ급비내병발증적발생솔비교，차이유통계학의의（P＜0．05）。재비두골류중도항조여비도항조비내병발증비교，차이유통계학의의（P＜0．05）。결론대우비두골류급Ⅲ、Ⅳ급비강내번성유두상류，영상도항하비내경수술우우전통비내경수술，특별재술전평개화학보수술중적안전성방면기도료유개치적보조작용，사득종류절제경철저，복발솔경저。
Objective To evaluate the clinical effect of image guided navigation system (IGNS) and traditional methods for nasal inverted papilloma and sinus osteoma .Methods 73 cases of nasal inverted papilloma and sinus osteoma patients were divided into the navigation group and the non-navigation group ,the navigation group was given image guidance endoscopic sinus surgery ,the non-navigation group was given traditional endoscopic sinus surgery .operative time ,the anesthesia time ,amount of bleeding ,compli-cations and postoperative effects of the two groups were analyzed .Results The anesthesia time of the two groups had no significant difference(P>0 .05) ,the operative time ,blood loss had significant difference(P< 0 .05) .Ⅰ ,Ⅱ level recurrence rate of the two grups in nasal inverted papilloma had no significant difference(P>0 .05) ,while in stage Ⅲ ,Ⅳ ,the difference of recurrence rate had significant difference(P<0 .05) .In sinus osteoma ,1 case of recurrence in the non-navigation group ,the navigation group had no re-currence .In nasal inverted papilloma ,the complications of the two grouos had significant difference (P<0 .05) ,there was no signifi-cantly difference in stage Ⅰ ,Ⅱ(P>0 .05) ,while had significant different in stage Ⅲ ,Ⅳ(P<0 .05) .In the sinus osteoma ,the com-plications of the two grouos had significant difference(P<0 .05) .Conclusion For sinus osteoma and Ⅲ ,Ⅳ level of nasal inverted papilloma ,IGNS could work well with endoscopic system ,improve operation accuracy and reduce complications .IGNS is of a useful tool for endoscopy sinus surgery and would make a great important development in future .