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[目的]探讨鼻内镜下切除鼻腔鼻窦内翻性乳头状瘤(NIP)的治疗效果和可行性。[方法]回顾性分析2005年10月～2010年8月行手术治疗的100例NIP患者的临床资料,行鼻侧切开术治疗57例(鼻侧切开组),行鼻内窥镜手术治疗42例(鼻内镜组)。术后随访1～3年,平均(32±11)个月,观察术后复发率和并发症发生率。[结果]鼻内镜组术后肿瘤复发率为18.6%,显著低于鼻侧切开组(29.3%),差异有统计学意义(χ2=6.574,P﹤0.01);Ⅱ、Ⅲ级患者术后肿瘤复发率均显著低于鼻侧切开组,差异有统计学意义(χ2=9.150、5.648,P﹤0.01);Ⅳ级患者术后肿瘤复发率显著高于鼻侧切开组,差异有统计学意义(χ2=9.100,P﹤0.01)。鼻内镜组术后并发症发生率为9.3%,显著低于鼻侧切开组(24.6),差异有统计学意义(χ2=8.200,P﹤0.01);Ⅱ、Ⅲ级患者术后并发症发生率均显著低于鼻侧切开组,差异有统计学意义(χ2=7.721、6.102,P﹤0.01);Ⅳ级患者术后并发症发生率均显著高于鼻侧切开组,差异有统计学意义(χ2=9.019,P﹤0.01)。而两组Ⅰ级患者术后肿瘤复发率和并发症发生率比较差异无统计学意义(χ2=1.761,2.361,P﹥0.05)。[结论]鼻内镜下切除治疗NIP临床效果好,术后复发率低、并发症少,但在治疗NIP时应根据Krouse分级选择合适的术式。
[Objective] To investigate the curative effect and feasibility of endoscopic sinus surgery for nasal inverted papilloma (NIP). [Methods] The clinical data of 100 patients with NIP who underwent surgical treatment from October 2005 to August 2010 were retrospectively analyzed. Fifty-seven patients (nasal incision group) underwent nasal dissection and underwent endoscopic sinus surgery Treatment of 42 cases (endoscopic group). The patients were followed up for 1 to 3 years with an average of (32 ± 11) months. The postoperative recurrence rate and complication rate were observed. [Results] The recurrence rate of nasal endoscopy group was 18.6%, which was significantly lower than that of nasal resection group (29.3%) (χ2 = 6.574, P <0.01) The recurrence rate of tumor was significantly lower than that of the nasal incision group (χ2 = 9.150,5.648, P <0.01). The recurrence rate of grade Ⅳ patients was significantly higher than that of nasal incision group, the difference was Statistical significance (χ2 = 9.100, P <0.01). The postoperative complication rate in nasal endoscopy group was 9.3%, which was significantly lower than that in nasal resection group (24.6%) (χ2 = 8.200, P <0.01) (Χ2 = 7.721,6.102, P <0.01). The incidence of postoperative complications in grade Ⅳ patients was significantly higher than that in nasal incision group, and the difference was statistically significant Statistical significance (χ2 = 9.019, P <0.01). There was no significant difference in the recurrence rate and complication between the two groups of grade Ⅰ patients (χ2 = 1.761, 2.361, P> 0.05). [Conclusion] Endoscopic resection of NIP has good clinical effect, low postoperative recurrence rate and few complications. However, appropriate surgical procedures should be selected according to Krouse classification in the treatment of NIP.