本文選題：內翻性乳頭狀瘤 + 鼻內鏡��； 參考：《浙江大學》2012年碩士論文

【摘要】：目的：探討鼻腔鼻竇內翻性乳頭狀瘤的手術策略,比較四種不同術式的臨床特點及選擇適應癥。 方法：回顧性分析浙江大學醫(yī)學院附屬邵逸夫醫(yī)院耳鼻咽喉-頭頸外科2002年1月至2011年2月期間收治的術前診斷為鼻腔鼻竇內翻性乳頭狀瘤的63例資料完整至少隨訪10月的患者。按照Krousel臨床分期和Kamel分級標準進行評估,其中T1期6例,T2期25例,T3期32例；Ⅰ級44例,Ⅱ級19例。行鼻竇內窺鏡術18例,鼻側切開術(lateral rhinotomy,LR)12例,鼻內鏡聯(lián)合Caldwell-Luc(CL)20例鼻內鏡輔助下鼻側切開術(lateral rhinotomy,LR)13例。比較四種常用術式的術后復發(fā)率和術中出血量。 結果：上述四種術式均能達到切除鼻腔鼻竇內翻性乳頭狀瘤病灶的目的,未出現嚴重的并發(fā)癥。術后平均隨訪3.2年,腫瘤復發(fā)率為：鼻側切開手術組25%；鼻內鏡手術組11.1%；鼻內鏡聯(lián)合Caldwell-Luc術組5.0%；鼻內鏡輔助下鼻側切開術組7.7%。四組總的復發(fā)率為11.1%。鼻內鏡組術中平均出血量T1期80±4.5m1；T2期113±3.8m1,T3期162±5.6m1,鼻內鏡組術中平均出血量明顯少于其他三組(p0.001)差異具有顯著統(tǒng)計學意義。 結論：上述四種術式均可用于治療鼻腔鼻竇內翻性乳頭狀瘤,Krousel臨床分期標準做為手術方式的選擇依據是簡便、可行的,kamel的臨床分級系統(tǒng)是指導臨床選擇手術方式的必要補充。T1、T2期,Ⅰ級的病例,行鼻內鏡手術是安全、有效的,T3期、Ⅱ級病例,推薦行鼻內鏡聯(lián)合鼻外入路(包括CL術和LR術)。
[Abstract]:Objective: to investigate the surgical strategy of inverted papilloma of nasal cavity and paranasal sinuses, and to compare the clinical features and selection indications of four different surgical methods.Methods: the data of 63 cases of nasal cavity and nasal sinus inverted papilloma diagnosed from January 2002 to February 2011 were analyzed retrospectively. The data of 63 cases of nasal cavity and nasal sinus varus papilloma diagnosed in the department of otolaryngology and head and neck surgery of run run Shaw Hospital affiliated to Zhejiang University Medical College were at least complete.Patients were followed up for 10 months.According to the Krousel clinical staging and Kamel classification criteria, there were 6 cases of T1 stage, 25 cases of T _ 3 stage, 44 cases of 鈪，

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