探讨鼻内镜下切除鼻内翻性乳头状瘤手术进路的选择及其与疗效的关系

目的：探讨鼻内镜下切除鼻内翻性乳头状瘤手术进路的选择及其与疗效的关系。方法：回顾性分析本院2005年5月-2012年5月接诊的26例经鼻内镜手术治疗的鼻腔鼻窦内翻性乳头状瘤患者资料。以国内通用的Krouse分期法将其分为四级，其中Ⅰ级3例，Ⅱ级8例，Ⅲ级9例，Ⅳ级6例。结果：在术后10~60个月的随访中，共有6例患者复发；在对复发病例再次进行手术之后，随访24个月未再复发；不同术式患者的复发情况、术中出血量和住院时间比较差异均有统计学意义（P〈0.05）。结论：作为治疗鼻内翻性乳头状瘤最安全有效的方法来说，当属鼻内镜手术无疑。然而需要根据Krouse分期法的分期根据不同患者选择不同手术。采用有效的治疗方法，可以促进患者病情的快速好转，可以减少肿瘤的残留和降低复发率。

Discussion on the Selection of Resection of Nasal Inverted Papilloma of Nasal Endoscopic Operation Approach and Its Relationship with Therapeutic Effect

Objective：To discuss the selection of resection of nasal inverted papilloma of nasal endoscopic operation approach and its relationship with therapeutic effect. Method：26 patients with the nasal endoscopic operation for treatment of nasal inverted papilloma in our hospital from 2005 May to 2012 May were retrospectively analyzed. With the domestic general Krouse stage were divided into four levels,Which gradeⅠwere 3 cases,gradeⅡwere 8 cases,gradeⅢwere 9 cases,gradeⅣwere 6 cases. Result：In the postoperative follow-up of 10-60 months,a total of six cases of relapse. Again on recurrence after surgery,were followed for 24 months without recurrence. Recurrence in patients with different operation,intraoperative blood loss and length of hospital stay compared differences were statistically significant（P〈0.05）. Conclusion：As a treatment for nasal inverted papilloma is the most safe and effective method,no doubt comes as endoscopic surgery. However,it should Krouse staging staging according to different patients according to different surgical options. It can facilitate the rapid improvement in the patient＇s condition,can reduce the residual tumor and reduce the relapse rate.