CAJ | 학술논문

目的比较不同手术方式治疗不同临床分级的鼻腔鼻窦内翻性乳头状瘤的疗效.方法选取60例鼻腔鼻窦内翻性乳头状瘤患者,17例采用鼻外入路,27例采用单纯鼻内镜,16例采用鼻内镜下联合柯-陆手术.比较三种手术方式的手术时间、术中出血量、住院时间以及术后的复发情况.结果三种手术方式手术时间差异无显著性(P＞0.05)；鼻外入路组术中出血量及住院时间均大于鼻内镜入路组或者鼻内镜下联合柯-陆手术组(P＜0.05).鼻外入路组术后复发率为29.4％,鼻内镜入路组复发率为25.9％,鼻内镜下联合柯-陆手术组复发率为25.0％,三组术后肿瘤复发率差异无显著性(P＞0.05);随着肿瘤Krouse级别增加,复发率呈上升趋势.结论鼻内镜手术治疗Krouse Ⅰ、Ⅱ级NIP损伤小,恢复快,对病变范围较大的Ⅲ期患者,鼻内镜下鼻内外联合入路是一种较好的选择.
목적 비교불동수술방식치료불동림상분급적비강비두내번성유두상류적료효.방법 선취60례비강비두내번성유두상류환자,17례채용비외입로,27례채용단순비내경,16례채용비내경하연합가-륙수술.비교삼충수술방식적수술시간、술중출혈량、주원시간이급술후적복발정황.결과 삼충수술방식수술시간차이무현저성(P＞0.05)；비외입로조술중출혈량급주원시간균대우비내경입로조혹자비내경하연합가-륙수술조(P＜0.05).비외입로조술후복발솔위29.4％,비내경입로조복발솔위25.9％,비내경하연합가-륙수술조복발솔위25.0％,삼조술후종류복발솔차이무현저성(P＞0.05);수착종류Krouse급별증가,복발솔정상승추세.결론 비내경수술치료Krouse Ⅰ、Ⅱ급NIP손상소,회복쾌,대병변범위교대적Ⅲ기환자,비내경하비내외연합입로시일충교호적선택.
Objective To evaluate the efficacy of different clinical criteria endoscopic surgical approaches for inverted papillomas of the nasal cavity and paranasal sinus.Methods 60 cases diagnosed as nasal inverted papilloma (NIP) were retrospectively analyzed.Among these patients,17 cases were treated by external approach surgery,27 cases by endoscopic surgery and 16 cases by endoscopy plus Caldwell-Luc approach resection.Comparison was made in three groups in respects of operation time,blood loss,hospitalization time and recovery.Results There were no obvious differences in operation time in three groups (P＞0.05).The blood loss and hospital time in external approach group were significantly higher than those in endoscopic group or endoscopy plus Caldwell-Luc group(P＜0.05).There was no statistical significant difference in the recurrence rate in three groups (P＞0.05).The recurrence rate was raised with the Krause stage increased.Conclusion For the cases of Krouse Ⅲ,the external approach is a good supplementary for the surgery under nasal endoscope.By using nasal endoscope united with external approach surgery,the tumor can be excised more thoroughly,with less residual and recurrence,and impairment can be cut down.