摘要
对78例鼻颅底肿瘤患者经鼻内镜下行微创手术治疗，考察其治疗效果、围术期并发症，并总结可供临床参照的手术操作要点。回顾性分析2012年1月～2014年6月笔者所在医院收治的78例鼻颅底肿瘤患者的临床资料。患者均经鼻内镜下行手术治疗。术后经病理活检确诊，如为恶性肿瘤，患者还需术后接受放射治疗。考察手术完成、肿瘤切除情况（切除率）、围术期并发症的发生及持续随访的结果。78例患者全部顺利完成手术。肿瘤全切率80．8％（63／78），次全切除率14．1％（11／78），大部分切除率5．1％（4／78）。术后病理结果显示良性肿瘤占53．8％（42／78），恶性肿瘤占46．2％（36／78）。围术期并发症的发生率为5．1％（4／78）。无致死病例。持续随访，术后1年良性肿瘤复发率11．9％（5／42），恶性肿瘤复发率25．0％（9／36）。术后3年恶性肿瘤复发率52．8％（19／36），病死率44．4％（16／36）。经鼻内镜下微创手术切除鼻腔、鼻窦侵犯至颅底或颅底的原发良、恶性肿瘤是简便、有效、安全的治疗方法。只要掌握好适应证，制定合理的手术路径，则鼻内镜下微创术切除或部分切除鼻颅底的肿瘤在临床是切实可行的。
To investigate the therapeutic effect and complications of 78 cases of nasal skull base tumor, and to investigate the therapeutic effect and complications. Clinical data of 78 cases of nasal skull base tumor in our hospital from June 2014 to January 2012 were retrospectively analyzed. The patients were all accepted with endoscopic surgery and confirmed by pathological biopsy, such as malignant tumor, all patients need to be treated with radiotherapy. The authors investigated the surgical treatment, tumor resection （resection rate）, the occurrence of perioperative complications and the follow-up results. 78 patients all successfully completed operation. The total resection rate was 80.8%, subtotal removal rate was 14. 1%, and most of the resection rate was 5.1%. The pathological results showed that 53.8% and 46.2% of malignant tumors. The incidence of perioperative complications was 5. 1%. No fatal case. The recurrence rate of 1 years after operation was 11.9%, and the recurrence rate of malignant tumor was 25%. The recurrence rate of malignant tumor was 52.8% the mortality rate was 44.4% 3 years after operation. The treatment of nasal endoscopic surgery, nasal cavity, nasal sinus invasion to the base of the skull base and the skull base of the primary benign and malignant tumor is simple, effective and safe. As long as the indications are well adapted to develop a reasonable surgical approach, endoscopic minimally invasive resection or partial removal of the tumors in the skull base is feasible.
出处
《医学与哲学（B）》
2016年第2期56-58,共3页
Medicine & Philosophy(B)
关键词
鼻颅底肿瘤
鼻内镜
手术治疗
nasal skull base tumor, nasal endoscopy, surgical treatment
