易长龙. 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[J]. 蚌埠医科大学学报, 2016, 41(10): 1312-1315. DOI: 10.13898/j.cnki.issn.1000-2200.2016.10.017
    引用本文: 易长龙. 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[J]. 蚌埠医科大学学报, 2016, 41(10): 1312-1315. DOI: 10.13898/j.cnki.issn.1000-2200.2016.10.017
    YI Chang-long. Three operation methods in the treatment of nasal inverted papilloma: a randomized controlled study[J]. Journal of Bengbu Medical University, 2016, 41(10): 1312-1315. DOI: 10.13898/j.cnki.issn.1000-2200.2016.10.017
    Citation: YI Chang-long. Three operation methods in the treatment of nasal inverted papilloma: a randomized controlled study[J]. Journal of Bengbu Medical University, 2016, 41(10): 1312-1315. DOI: 10.13898/j.cnki.issn.1000-2200.2016.10.017

    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

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

    • 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。

       

      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.

       

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