【摘要】 目的 比较鼻内镜微创手术与传统手术治疗鼻腔鼻窦恶性肿瘤的临床效果。方法 将120例鼻腔鼻窦恶性肿瘤患者根据手术方式的不同分为对照组(传统手术)、观察组(鼻内镜微创手术),各60例。比较两组手术相关指标、应激指标水平、嗅觉功能与通气功能、并发症发生情况。结果 观察组手术时间(40.23±16.33)min、住院时间(4.38±1.53)d、鼻腔内创面愈合时间(26.11±3.72)d短于对照组的(65.31±10.77)min、(8.77±1.82)d、(30.11±3.90)d,术中出血量(35.63±3.56)ml少于对照组的(47.11±3.85)ml,术后6 h视觉模拟评分法(VAS)评分(3.13±1.12)分低于对照组的(5.51±1.22)分(P<0.05)。术后2 h,观察组血清皮质醇(237.65±50.33)ng/ml、去甲肾上腺素(242.73±48.66)pg/ml低于对照组的(274.38±56.14)ng/ml、(281.41±50.21)pg/ml(P<0.05)。术后3个月,两组嗅觉功能评分、气道阻力均低于本组术前,且观察组嗅觉功能评分(1.57±0.45)分、气道阻力(0.44±0.10)kPa/(L·s)低于对照组的(2.16±0.60)分、(0.86±0.36)kPa/(L·s)(P<0.05)。术后3个月,观察组并发症发生率3.33%低于对照组的13.33%(P<0.05)。结论 鼻内镜微创手术在治疗鼻腔鼻窦恶性肿瘤方面相较于传统开放手术具有明显的优势,有助于减轻患者生理应激反应,减少术后嗅觉功能的损害和气道阻力的增加,有效降低术后并发症发生率。更多还原

【Abstract】 Objective To compare the clinical efficacy of nasal endoscopic minimally invasive surgery and traditional surgery in the treatment of nasal and paranasal malignant tumors. Methods 120 patients with nasal and paranasal malignant tumors were divided into control group(traditional surgery) and observation group(nasal endoscopic minimally invasive surgery) according to different surgical methods, with 60 cases in each group. The levels of surgery-related indicators, stress indicators, olfactory function and ventilation function, and the occurrence of complications were compared between the two groups. Results The operation time in the observation group was(40.23±16.33) min, the hospital length of stay was(4.38±1.53) d, and the nasal wound healing time was(26.11±3.72) d, which were shorter than those in the control group [(65.31±10.77) min,(8.77±1.82) d, and(30.11±3.90) d]; the intraoperative blood loss(35.63±3.56) ml was less than the control group’s(47.11±3.85) ml; the Visual Analogue Scale(VAS) score(3.13±1.12) points at 6 h postoperatively was lower than the control group’s(5.51±1.22) points(P<0.05). 2 h postoperatively, the observation group had serum cortisol of(237.65±50.33) ng/ml and norepinephrine of(242.73±48.66) pg/ml, which were lower than those in the control group [(274.38±56.14) ng/ml and(281.41±50.21) pg/ml](P<0.05). 3 months postoperatively, the olfactory function score and airway resistance in both groups were lower than those in this group preoperatively. Moreover, the olfactory function score(1.57±0.45) points and airway resistance(0.44±0.10) kPa/(L·s) in the observation group were lower than those in the control group [(2.16±0.60) points and(0.86±0.36) kPa/(L·s)](P<0.05). 3 months postoperatively, the incidence of complications in the observation group was 3.33%, which was lower than the control group’s 13.33%(P<0.05). Conclusion Compared with traditional open surgery, nasal endoscopic minimally invasive surgery has obvious advantages in the treatment of nasal and paranasal malignant tumors, which can help to reduce the physiological stress response of patients, reduce the damage of postoperative olfactory function and the increase of airway resistance, and effectively reduce the incidence of postoperative complications.更多还原