摘要
目的:分析经鼻内镜手术治疗的鼻腔鼻窦恶性肿瘤(sinonasal malignancy, SNM)患者的临床疗效及预后,比较手术前后SNM患者生活质量的变化。方法:本研究为单中心回顾性队列研究,连续收集2016年1月至2020年12月期间遂宁市中心医院耳鼻咽喉科收治的经鼻内镜手术治疗的SNM患者93例作为研究对象,收集患者相关临床资料,随访其预后并分析影响预后的相关危险因素;采用鼻腔鼻窦结局测试22条量表(Sinonasal Outcome Test-22, SNOT-22)、前颅底生活质量问卷调查表(Anterior Skull Base Questionnaire, ASBQ)评价患者手术前后的生活质量。结果:本研究共纳入93例包括鳞状细胞癌、嗅神经母细胞瘤、腺样囊性癌等多种病理类型的SNM患者,T分期以T4期居多(37例,39.79%),2例发生淋巴结转移,1例发生远处转移。88例完成随访患者,经历39(6~87)个月中位随访时间,随访期间肿瘤复发34例、死亡8例、无瘤存活54例,术后1年、3年、5年的总体生存率分别为93.98%、81.03%、77.32%。SNOT-22量表评价:与手术前相比,患者的耳及头面部症状、心理状况、睡眠状况明显改善,差异均有统计学意义(P<0.05),在鼻部症状维度中,患者术后嗅觉减退症状加重、鼻塞情况得以改善;ASBQ量表评价:与手术前相比,患者的一般表现、活力明显改善,差异均有统计学意义(P <0.05),在特殊症状维度中,患者术后的嗅觉和味觉出现减退症状。结论:选择合适的SNM患者进行鼻内镜治疗,可以取得良好的手术效果及预后,患者术后生活质量改善明显,但术后嗅觉、味觉减退仍然是需要重点关注的问题。
Objective:To analyze the clinical efficacy and prognosis of patients with sinonasal malignancy(SNM)treated by endoscopic endonasal approach,and evaluate the changes in quality of life of SNM patients before and after surgery.Methods:In the single-center retrospective cohort study,93 SNM patients who underwent endoscopic endonasal approach in the department of otolaryngology in Suining Central Hospital from January 2016 to December 2020 were taken as the research objects.Clinical data of patients were collected,their prognosis were fllowed up,and the risk factors affecting the prognosis were analyzed.The quality of life of patients before and after surgery was evaluated by using Sinonasal Outcome Test-22(SNOT-22)and Anterior Skull Base Questionnaire(ASBQ).Results:A total of 93 patients with SNM including squamous cell carcinoma,olfactory neuroblastoma,adenoid cystic carcinoma and other pathological types were included in this study.The majority of patients were in T4 stage(37 cases,39.79%).2 cases had lymph node metastasis and 1 case had distant metastasis.A follow-up with the median duration of 39(6~87)months was completed in 88 patients.During the follow-up,34 patients had tumor recurrence,8 patients died,and 54 patients survived without tumor.The 1-,3-and 5-year overall survival were 93.98%,81.03%and 77.32%,respectively.The results of SNOT-22 showed that the ear,head and face symptoms,mental status and sleep status of the patients significantly improved afer surgery(P<0.05);in the dimension of nasal symptoms,postoperative anosmia aggravated and nasal congestion improved.The results of ASBQ showed that the general performance and vitality of the patients significantly improved after surgery(P<0.05);in the dimension of special symptoms,the smeland taste senseofthe patients decreased after operation.Conclusion:Selecting appropriate SNM patients for nasal endoscopic treatment can achieve good surgical results and prognosis.Postoperative quality of life of patients treated by endoscopic endonasal approach has improv
作者
谭浠
税磊
杨宇
赵春蓉
余文兴
Tan Xi;Shui Lei;Yang Yu;Zhao Chunrong;Yu Wenxing(Department of Otorhinolaryngology,Suining Central Hospital,Suining 629000,Sichuan,China)
出处
《肿瘤预防与治疗》
2023年第12期1026-1031,共6页
Journal of Cancer Control And Treatment
关键词
鼻腔鼻窦恶性肿瘤
鼻内镜手术
预后
生活质量
Sinonasal malignancies
Nasal endoscopic surgery
Prognosis
Quality of life
