双径路鼻内镜手术治疗上颌窦癌的临床探讨(1)
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[摘要] 目的：探讨双径路鼻内镜手术治疗上颌窦癌的可行性。方法：回顾分析33例上颌窦癌患者的临床资料，其中15例患者采用双径路鼻内镜手术方式，18例患者采用传统手术方式，术后均接受6MV-X线放射治疗(60～70) Gy/(30～35)F/(6～7)W，对比两种手术方式治疗的效果。结果：双径路鼻内镜手术+放疗组，5年生存率为45.4%。传统手术+放疗组，5年生存率为42.9%。两组5年生存率比较，差异无统计学意义(P>0.05)。结论：双径路鼻内镜手术可以彻底切除上颌窦癌，优点是创伤小，避免了面容损毁，提高了患者生存质量，但有待于进一步开展大样本、随机分组、长期随访的临床研究。
[关键词] 内镜检查；鼻腔；上颌窦肿瘤；鳞状细胞
[中图分类号] R739.81 [文献标识码]B[文章编号]1674-4721(2011)06(b)-092-02
Clinical study using double-way endoscopic sinus surgery to treatment the carcinoma of maxillary sinus
LI Jiansheng, QIAO Xiujun, MU Shanyu, MA Jian
Department of Otolaryngology, the People′s Hospital of Rizhao City, Shandong Province, Rizhao 276826, China
[Abstract] Objective: To discuss the feasibility and therapeutic efficacy of carcinoma of maxillary sinus through double-way endoscopic sinus surgery. Methods: The clinical data of 33 carcinoma of maxillary sinus were analyzed retrospectively. Among them, 15 cases of carcinoma of maxillary sinus were resected under double-way endoscopic sinus surgery; 18 cases of carcinoma of maxillary sinus were resected through traditional surgery. 33 patients with carcinoma of maxillary sinus were treated by radiotherapy (60-70) Gy/(30-35)F/(6-7) W. Results: The five year survival rate were 45.4% and 42.9% for patients in double-way endoscopic sinus surgery group and traditional surgery group. Two group of 5 year survival rate comparisons, difference non-statistics significance (P>0.05). Conclusion: By double-way endoscopic sinus surgery, carcinoma of maxillary sinus can be thoroughly resected. The advantages are mini-invasive and avoidance of facial disfigured so as to improve the quality of life of patients. Large amount of cases, random clinical study with long-term follow-up are still needed to verify the feasibility and efficacy of double-way endoscopic sinus surgery.
[Key words] Endocope; Nasal cavity; Maxillary sinus neoplasms; Squamous cell
鼻内镜手术主要治疗对象是慢性鼻窦炎、鼻息肉，近年来，该技术在国内得到了较快发展，手术范围拓宽延伸，已涉及耳鼻喉-头颈外科诸多领域，尤其对鼻腔、鼻窦良性病变的处理上具有创伤小、保存结构功能完整的优势。对于鼻腔-鼻窦恶性肿瘤，是否可在鼻内镜下手术治疗，尚无统一见解。本科2000年1月～2007年3月收治33例上颌窦癌患者，对15例患者采用双径路鼻内镜手术，进行临床探讨，与传统手术方式治疗的18例患者进行比较，在患者术后均进行放疗治疗的情况下 ......
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