李章健 朱海路 赵红

摘 要 目的：比较鼻内镜下泪前隐窝入路与中鼻道联合下鼻道开窗入路治疗上颌窦良性病变的效果。方法：收集2016年8月至2017年8月收治的上颌窦良性病变患者60例，随机分为观察组和对照组各30例，对照组采用经中鼻道联合下鼻道开窗入路治疗，观察组采用经鼻内镜下泪前隐窝入路治疗，比较两组治疗效果。结果：观察组真菌性上颌窦炎及上颌窦内翻乳头状瘤患者平均手术时间、术中平均出血量、术后平均住院时间均显著低于对照组（P<0.05）。观察组真菌性上颌窦炎及上颌窦内翻乳头状瘤患者术后并发症总发生率及复发率均显著低于对照组（P<0.05）。结论：经泪前隐窝入路治疗上颌窦良性病变创伤更小、术后并发症发生率和复发率更低，效果更佳。

关键词 上颌窦良性病变；鼻内镜；泪前隐窝；中鼻道；下鼻道开窗

中图分类号：R739.62 文献标志码：A 文章编号：1006-1533（2018）20-0023-02

Comparison of under nasal endoscope anterior lacrimal recess approach with middle nasal passage combined with opening of the lower nasal passage in the treatment of benign lesions of maxillary sinus

LI Zhangjian， ZHU Hailu， ZHAO Hong（Department of Otorhinolaryngology， Head and Neck Surgery of Central Hospital of Xinyu Iron and Steel Group Co.， Jiangxi Province 338000， China）

ABSTRACT Objective： To compare the effect of under nasal endoscope anterior lacrimal recess approach with middle nasal approach combined with opening of the lower nasal passage in the treatment of maxillary sinus benign lesions. Methods： Sixty patients with benign lesions of the maxillary sinus admitted from August 2016 to August 2017 were collected and randomly divided into an observation group and a control group with 30 cases each. The control group was treated with middle nasal passage combined with opening of the lower nasal passage， and the observation group was treated with anterior lacrimal recess approach under nasal endoscope， and the therapeutic effects of the two groups were compared. Results： The average operation time， mean intraoperative blood loss， and average postoperative hospital stay of patients with fungal maxillary sinusitis and maxillary sinus inverted papilloma were significantly lower in the observation group than in the control group（P<0.05）. The total incidence of complications and recurrence rate in patients with fungal maxillary sinusitis and inverted papilloma of the maxillary sinus after surgery in the observation group were significantly lower than those in the control group（P<0.05）. Conclusion： Treatment of benign lesions of the maxillary sinus through anterior lacrimal recess approach is less traumatic， postoperative complication rate and recurrence rate are lower and the effect is better.

KEY WORDS maxillary sinus benign lesions； nasal endoscope； anterior lacrimal recess； middle nasal meatus； opening of the lower nasal passage

上頜窦良性病变临床发病率较高，手术是治疗该病的主要手段[1]。研究微创、科学的入路方式对改善患者预后有重要意义[2]。本文采用鼻内镜下泪前隐窝入路治疗上颌窦良性病变，并与中鼻道联合下鼻道开窗入路治疗进行比较，以期为开展手术提供指导，现报道如下。

1 资料与方法

1.1 一般资料

收集2016年8月至2017年8月新余钢铁集团公司中心医院收治的上颌窦良性病变行择期行手术患者60例，均经常规CT或MRI检查结合病理组织学检查确诊，且均无头颈手术史，符合手术适应证。将患者按照随机数字表法分为观察组和对照组各30例。观察组中男性18例，女性12例，年龄18～68岁，平均（52.66±8.17）岁，病程0.5～7年，平均（3.02±0.97）年；对照组中男性19例，女性11例，年龄18～68岁，平均（52.58±8.03）岁，病程0.5～7年，平均（3.03±0.95）年。两组患者的基线资料差异无统计学意义（P>0.05）。排除合并其他器质性疾病、免疫系统疾病或血液系统疾病者，有精神疾病或交流障碍者。……