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目的:分析影响鼻内镜下鼻咽纤维血管瘤(JNA)切除术预后的相关因素。方法:回顾性分析47例行鼻内镜下JNA切除术患者的病例资料,观察记录既往治疗情况、肿瘤累及范围、术前是否行血管栓塞、肿瘤供血动脉、手术步骤、随访时间及是否复发。选择既往手术史、颈内动脉系统分支供血、术前栓塞、翼突根海绵状骨受累、蝶骨大翼受累、翼肌间隙受累、颞下窝受累、眼眶受累等8项临床指标进行χ2检验单因素分析,探讨上述因素对复发是否存在影响。结果:47例患者均在全身麻醉下行鼻内镜下鼻咽纤维血管瘤切除术,随访12~87个月(中位随访期35个月),随访期内共6例复发。χ2检验示翼突根海绵状骨受累与复发相关(P<0.05)。既往手术史、颈内动脉系统分支供血、术前栓塞、颞下窝受累、眼眶受累、翼肌间隙受累、蝶骨大翼受累等因素与复发之间的相关性无统计学意义(P>0.05)。影像学检查示复发位点位于翼突根附近。结论:翼突根海绵状骨受累与鼻内镜下JNA切除术后复发相关,在内镜手术及随访中应得到充分重视。
Objective: To analyze the related factors that influence the prognosis of nasopharyngeal hemangioma (JNA) resection under endoscopy. Methods: A retrospective analysis of 47 cases undergoing endoscopic sinus surgery in patients with JNA data were recorded and observed the past treatment, tumor coverage, preoperative embolism, tumor feeding artery, surgical procedures, follow-up time and recurrence. Eight clinical indexes such as history of surgery, branch of internal carotid artery supplying blood, preoperative embolization, cavernous bone of the wing root, involvement of the sphenoid wing, involvement of the wing muscle space, involvement of the infratemporal fossa, orbital involvement were determined byχ2 test Univariate analysis to explore whether these factors have an impact on the recurrence. Results: All the 47 patients underwent nasal endoscopic nasopharyngeal angiofibroma resection under general anesthesia. The patients were followed up for 12 to 87 months (median follow-up period was 35 months), and 6 patients relapsed during the follow-up period. Chi-square test showed that there was a correlation between the involvement of spongiform cavernous bone and the recurrence (P <0.05). There was no significant correlation between the recurrence rate and the recurrence of previous surgery, blood supply to the branch of internal carotid artery, preoperative embolization, infratemporal fossa invasion, orbital involvement, interspinous space involvement, ). Imaging studies showed that the site of recurrence was located near the root of the wing. Conclusion: The involvement of cavernous bone in the root of pancreas is related to the relapse after endoscopic JNA resection. It should be given sufficient attention during endoscopic surgery and follow-up.