摘要
目的探讨彭氏电凝切割器于鼻内镜下切除上颌窦KrouseⅡ、Ⅲ期内翻性乳头状瘤(inverted papilloma,IP)的手术方法和临床价值。方法回顾性分析2016年8月至2020年5月江苏省无锡市第九人民医院应用彭氏切割吸引器于鼻内镜下切除上颌窦KrouseⅡ、Ⅲ期IP 18例患者的临床资料,其中15例患者(Ⅱ期10例、Ⅲ期5例)行单纯内镜手术,剩余3例患者(均为Ⅲ期)采用联合入路手术(单纯鼻内镜手术+泪前隐窝入路或柯氏入路),观察患者临床效果。结果18例患者术后随访5个月。鼻内镜下检查见中鼻道开窗口通畅,上颌窦表面光滑,下鼻甲形态良好。行单纯内镜手术患者中有1例复发,复发率为5.56%,复发者再次行泪前隐窝入路切除肿瘤,术后未再复发;采用联合入路手术的3例患者,术后5个月无复发。结论彭氏电凝切割器于鼻内镜下经中鼻道开口切除上颌窦KrouseⅡ、Ⅲ期IP安全、有效,大部分能完成肿瘤切除手术;术中根据肿瘤范围,决定是否采用联合径路进行手术,以取得最佳疗效。
Objective To investigate the surgical method and clinical value of Peng's electrocoagulation cutter in endoscopic sinus surgery for Krouse stage II and III inverted papilloma(IP)in maxillary sinus.Methods From August 2016 to May 2020,the clinical data of 18 patients with Krouse stage II and III IP in the Ninth People's Hospital of Wuxi City were retrospectively analyzed,15 patients(10 cases of stage II and 5 cases of stage III)underwent simple endoscopic surgery,the combined approach(simple endoscopic surgery+anterior lacrimal recess approach or Kirschner's approach)was used in 3 patients(all stage III),and the clinical effects were observed.Results 18 patients were followed up for 5 months.Endoscopic examination showed that the middle meatus window was unobstructed,the surface of maxillary sinus was smooth,and the inferior turbinate was in good shape.1 case which underwent simple endoscopic surgery recurred,the recurrence rate was 5.56%,the recurrent patient underwent anterior lacrimal recess approach for tumor resection again,and no recurrence was found after surgery;3 patients operated with the combined approach had no recurrences 5 months postoperatively.Conclusion Peng's electrocoagulation cutter is safe and effective in the treatment of maxillary sinus Kruse stageⅡandⅢstage IP through the middle meatus opening under nasal endoscope,and can complete most of the tumor resection operations.According to the tumor scope,we decide whether to use the combined approach to achieve the best curative effect.
作者
邱景山
QIU Jingshan(The Ninth People's Hospital of Wuxi City,Wuxi,Jiangsu 214062,China)
出处
《大医生》
2020年第24期21-23,共3页
Doctor
关键词
鼻内镜手术
上颌窦
内翻性乳头状瘤
泪前隐窝
nasal endoscopic surgery
maxillary sinus
inverted papilloma
anterior lacrimal recess
