鼻腔鼻窦内翻性乳头状瘤手术治疗的临床研究

发布时间：2018-04-14 15:28

  本文选题：内翻性乳头状瘤 + 鼻内镜　； 参考：《浙江大学》2012年硕士论文

【摘要】：目的：探讨鼻腔鼻窦内翻性乳头状瘤的手术策略,比较四种不同术式的临床特点及选择适应症。 方法：回顾性分析浙江大学医学院附属邵逸夫医院耳鼻咽喉-头颈外科2002年1月至2011年2月期间收治的术前诊断为鼻腔鼻窦内翻性乳头状瘤的63例资料完整至少随访10月的患者。按照Krousel临床分期和Kamel分级标准进行评估,其中T1期6例,T2期25例,T3期32例；Ⅰ级44例,Ⅱ级19例。行鼻窦内窥镜术18例,鼻侧切开术(lateral rhinotomy,LR)12例,鼻内镜联合Caldwell-Luc(CL)20例鼻内镜辅助下鼻侧切开术(lateral rhinotomy,LR)13例。比较四种常用术式的术后复发率和术中出血量。 结果：上述四种术式均能达到切除鼻腔鼻窦内翻性乳头状瘤病灶的目的,未出现严重的并发症。术后平均随访3.2年,肿瘤复发率为：鼻侧切开手术组25%；鼻内镜手术组11.1%；鼻内镜联合Caldwell-Luc术组5.0%；鼻内镜辅助下鼻侧切开术组7.7%。四组总的复发率为11.1%。鼻内镜组术中平均出血量T1期80±4.5m1；T2期113±3.8m1,T3期162±5.6m1,鼻内镜组术中平均出血量明显少于其他三组(p0.001)差异具有显著统计学意义。 结论：上述四种术式均可用于治疗鼻腔鼻窦内翻性乳头状瘤,Krousel临床分期标准做为手术方式的选择依据是简便、可行的,kamel的临床分级系统是指导临床选择手术方式的必要补充。T1、T2期,Ⅰ级的病例,行鼻内镜手术是安全、有效的,T3期、Ⅱ级病例,推荐行鼻内镜联合鼻外入路(包括CL术和LR术)。
[Abstract]:Objective: to investigate the surgical strategy of inverted papilloma of nasal cavity and paranasal sinuses, and to compare the clinical features and selection indications of four different surgical methods.Methods: the data of 63 cases of nasal cavity and nasal sinus inverted papilloma diagnosed from January 2002 to February 2011 were analyzed retrospectively. The data of 63 cases of nasal cavity and nasal sinus varus papilloma diagnosed in the department of otolaryngology and head and neck surgery of run run Shaw Hospital affiliated to Zhejiang University Medical College were at least complete.Patients were followed up for 10 months.According to the Krousel clinical staging and Kamel classification criteria, there were 6 cases of T1 stage, 25 cases of T _ 3 stage, 44 cases of 鈪，

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