258例鼻-鼻窦良、恶性肿瘤的临床特征分析

发布时间：2018-08-29 19:26

【摘要】：目的分析鼻-鼻窦良、恶性肿瘤的临床特征,以提高其临床诊断准确性。方法对经病理证实的258例鼻-鼻窦肿瘤患者的临床资料进行回顾性分析并对比良、恶性肿瘤的临床差异。结果鼻-鼻窦肿瘤临床症状表现多样。鼻出血或涕中带血、头痛、面部麻木或疼痛、眼痛或溢泪所占比率比较,恶性肿瘤患者明显高于良性肿瘤患者(P0.05);行手术治疗的196例患者中,良、恶性肿瘤术前石蜡病检与术后石蜡病检符合率相比,差异无统计学意义(P0.05)。行手术治疗的63例恶性肿瘤中,共行232个切缘冰冻病检,与术后石蜡冰冻病检符合率为98.70%(229/232)。34例术中冰冻与术后石蜡病检符合率为91.18%(31/34),其中行术中即时冰冻6例,66.67%(4/6)的患者与术前石蜡活检诊断不相符,从良性变为恶性。结论鼻-鼻窦肿瘤临床表现缺乏特异性,术中快速冰冻病检有利于提高诊断率;恶性肿瘤的切缘应行连续冰冻病检。
[Abstract]:Objective to analyze the clinical features of benign and malignant tumors of nasal and paranasal sinuses and to improve their diagnostic accuracy. Methods the clinical data of 258 patients with naso-paranasal sinus tumor confirmed by pathology were retrospectively analyzed and the clinical differences between benign and malignant tumors were compared. Results the clinical symptoms of nasal-paranasal sinus tumors were varied. The proportion of bleeding, headache, facial numbness or pain, eye pain or tears in patients with nosebleed or snot was significantly higher in patients with malignant tumors than in patients with benign tumors (P0.05). There was no significant difference in the coincidence rate between preoperative and postoperative paraffin detection of malignant tumors (P0.05). Of 63 cases of malignant tumors treated by operation, 232 were examined with frozen margin. The coincidence rate was 98.70% (229 / 232). The coincidence rate of intraoperative freezing and postoperative paraffin was 91.18% (31 / 34). Among them, 66.67% (4 / 6) of the patients who underwent intraoperative immediate freezing did not agree with the diagnosis of preoperative paraffin biopsy, from benign to malignant. Conclusion the clinical manifestations of naso-paranasal sinus tumors are lack of specificity, and rapid intraoperative frozen examination is helpful to improve the diagnostic rate, and the incised margin of malignant tumors should be examined continuously.
【作者单位】：重庆医科大学附属第一医院耳鼻咽喉科;
【基金】：国家临床重点专科建设项目经费资助[卫办医政函(2012)649号] 重庆市卫生计生委科研项目(2015HBRC004) 重庆市自然科学基金重点项目(cstc2015jcyjB0028) 重庆市研究生科研创新项目(CYS15121)
【分类号】：R739.62

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