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目的探讨鼻内镜在鼻腔鼻窦内翻性乳头状瘤(SNIP)切除手术中的作用及SNIP患者的最佳手术方式选择。方法回顾性分析手术治疗的207例SNIP患者的临床资料,按照不同手术方式分为传统手术组(95例)和鼻内镜手术组(112例),其中鼻内镜手术组患者按照是否联合鼻外入路又分为单纯鼻内镜手术组(52例)和鼻内镜联合鼻外入路组(60例)。所有患者手术后定期随访。结果传统手术组患者的肿瘤复发率为44.2%,鼻内镜手术组患者的肿瘤复发率为14.3%,其中单纯鼻内镜手术组患者的肿瘤复发率为23.1%,鼻内镜联合鼻外入路组患者的肿瘤复发率为6.7%。采用鼻内镜联合鼻外入路可缩短手术时间,鼻内镜手术组患者平均住院时间低于传统手术组患者。结论鼻内镜的介入使用能够降低手术切除SNIP的复发率,提高SNIP手术切除的治疗效果。借助鼻内镜的高分辨率优势,SNIP患者采用鼻内镜联合鼻外入路手术可取得更好的疗效,值得临床进一步推广使用。
Objective To explore the role of endoscopic sinus surgery in nasal sinus inverted papilloma (SNIP) resection and the optimal surgical approach for patients with SNIP. Methods The clinical data of 207 patients with SNIP undergoing surgical treatment were retrospectively analyzed. According to the different surgical methods, 95 cases were divided into two groups: conventional surgery group (n = 95) and endoscopic sinus surgery group (112 cases) Out-path is divided into simple endoscopic surgery group (52 cases) and endoscopic nasal approach group (60 cases). All patients were followed up regularly after surgery. Results The tumor recurrence rate was 44.2% in the traditional surgery group and 14.3% in the endoscopic surgery group, of which the recurrence rate was 23.1% in the simple endoscopic surgery group. Nasal endoscopy combined with nasal endoscopy The recurrence rate of patients in the road group was 6.7%. The use of endoscopic nasal approach can shorten the operation time, the average length of stay in patients undergoing endoscopic surgery was lower than that in the conventional surgery group. Conclusion The interventional use of endoscopic sinus surgery can reduce the recurrence rate of surgical resection of SNIP and improve the therapeutic effect of SNIP surgical resection. With the advantages of high resolution of endoscopic, SNIP patients with nasal endoscopic surgery combined with nasal approach can achieve better results, it is worth further promotion of clinical use.