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目的分析鼻内镜下应用低温等离子射频技术切除鼻腔恶性肿瘤的疗效。方法回顾性分析2014年1月至2015年1月诊治并完成1年随访的26例鼻腔鼻窦恶性肿瘤患者的临床资料。所有患者均在鼻内镜下应用低温等离子射频实施手术,其中鳞状细胞癌14例,腺样囊性癌7例,恶性黑色素瘤1例,异位脑膜瘤Ⅱ级2例,神经内分泌癌1例,嗅母细胞癌1例。记录患者手术时间、术中出血量,术后并发症以及1年随访复发情况。结果术中出血量为30~650 ml,中位出血量为160 ml,手术用时40~95 min,中位手术时间为65 min。术后2个月术腔上皮化均良好,未出现出血等并发症。随访1年通过鼻窦的CT或MRI检查,1例低分化上颌窦鳞状细胞癌复发,其余未见肿瘤复发。复发患者采用鼻侧切开进路辅助睑下缘切口,切除眶外下壁复发肿瘤组织,后复查6个月未见复发。结论鼻内镜下应用低温等离子射频手术治疗鼻腔鼻窦恶性肿瘤具有出血少、损伤小、手术时间短等优点。
Objective To analyze the curative effect of nasal endoscopic resection of nasal malignant tumor by using low temperature plasma radio frequency technique. Methods The clinical data of 26 patients with nasal sinus cancer who were diagnosed and treated from January 2014 to January 2015 and followed up for 1 year were retrospectively analyzed. All patients underwent endoscopic sinus surgery using low temperature plasma radio frequency, including squamous cell carcinoma in 14 cases, adenoid cystic carcinoma in 7 cases, malignant melanoma in 1 case, ectopic meningioma in 2 cases, neuroendocrine carcinoma 1 Cases, Olfactory B cell carcinoma in 1 case. The operation time, intraoperative blood loss, postoperative complications and recurrence of 1-year follow-up were recorded. Results The intraoperative blood loss was 30 ~ 650 ml, the median amount of bleeding was 160 ml, the operation time was 40 ~ 95 min, and the median operation time was 65 min. 2 months after surgery, epithelialization were good, no bleeding complications. Follow-up 1 year through CT or MRI of the sinuses, a case of poorly differentiated maxillary sinus squamous cell carcinoma recurrence, the rest no tumor recurrence. Recurrence patients with nasal incision approach to aid the lower eyelid incision, resection of the orbital wall recurrence of tumor tissue, no recurrence after 6 months of review. Conclusion The application of low temperature plasma radiofrequency ablation under nasal endoscopy for the treatment of nasal sinus cancer has the advantages of less bleeding, less damage and shorter operation time.