摘要
目的目前关于低温等离子消融术治疗鼻咽纤维血管瘤(JNA)的疗效研究较少。文中旨在探讨鼻内镜下低温等离子消融术治疗JNA的临床疗效,为JNA的有效治疗提供借鉴。方法回顾性分析2012年1月至2018年12月南京大学附属鼓楼医院耳鼻咽喉头颈外科38例JNA患者的临床资料。根据术式不同分为等离子组(采用鼻内镜下低温等离子消融术切除肿瘤,n=26)、对照组(采用传统术式以电刀、单/双极电凝分离并切除肿瘤,n=12)。统计分析比较2组患者的手术时间、Lund-Mackay镜下评分、并发症发生率、视觉模拟量表(VAS)评分等。结果等离子组术后Lund-Mackay镜下评分Ⅰ、Ⅱ级高于对照组,Ⅲ、Ⅳ级低于对照组(P<0.05)。等离子组术后鼻腔黏膜上皮化时间较对照组缩短[(2.3±0.1)个月vs(3.5±0.1)个月],差异有统计学意义(P<0.05)。等离子组患者术后并发症发生率、术后复发率(7.7%、3.8%)较对照组(38.5%、16.7%)明显降低(P<0.05)。等离子组术后3d、2个月、6个月、12个月VAS评分明显低于对照组(P<0.05)。结论鼻内镜下低温等离子消融术治疗JNA的疗效较好,值得临床推广。
Objective The aim of this article was to investigate the effect of nasal endoscopic surgery(NES)using low-temperature plasma radiofrequency(LTPRF)in the treatment of juvenile nasopharyngeal angiofibroma(JNA).Methods We retrospectively analyzed the clinical data on 38 cases of JNA treated by NES+LTPRF(n=26)or conventional surgical resection(control,n=12)in Drum Tower Hospital of Nanjing University School of Medicine from January 2012 to December 2018.We compared the operative time,postoperative Lund-Mackay endoscopy scores(LMES),incidence of complications,postoperative recovery,rate of recurrence,and Visual Analogue Scale(VAS)scores between the two groups of patients.Results The rates of LMES gradesⅠandⅡwere significantly higher while those of gradesⅢandⅣremarkably lower in the NES+LTPRF than in the control group(P<0.05).Compared with the controls,the patients of the NES+LTPRF group showed markedly shorter time of nasal mucosa epithelialization([3.5±0.1]vs[2.3±0.1]mo,P<0.05)and lower rates of postop-erative complications(38.5%vs 7.7%,P<0.05),recurrence(16.7%vs 3.8%,P<0.05),and VAS scores at 3 days,2 months,6 months and 12 months after surgery(P<0.05).Conclusion NES+LTPRF is an effective strategy for the treatment of juvenile nasopharyngeal angiofibroma and worthy of a wide clinical application.
作者
李盈盈
麻晓峰
LI Ying-ying;MA Xiao-feng(Department of Otorhinolaryngology,Children’s Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China;Department of Otolaryngology Head and Neck Surgery,Drum Tower Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu,China)
出处
《医学研究生学报》
CAS
北大核心
2019年第4期397-400,共4页
Journal of Medical Postgraduates
关键词
鼻咽纤维血管瘤
低温等离子消融术
鼻内镜
疗效
juvenile nasopharyngeal angiofibroma
low-temperature plasma radiofrequency
endoscopic surgery
efficacy
