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目的:初步探讨鼻中隔恶性肿瘤在鼻内镜下手术深浅层次问题。方法:将19例适应鼻内镜下手术的鼻中隔恶性肿瘤患者,根据肿瘤的大小、部位、浸润程度、手术过程探查情况分3组进行治疗。第1组(6例)实施第1层次手术治疗,第2组(9例)实施第2层次手术与部分患者加放疗,第3组(4例)实施第3层次手术与全部患者加放疗。结果:第1组中无瘤生存4例,局部复发2例;第2组中无瘤生存5例,局部复发2例,局部转移1例,死亡1例;第3组中无瘤生存2例,局部复发1例,局部转移1例。3组之间的疗效比较差异无统计学意义(P>0.05)。所有患者5年生存率为94.7%,5年无瘤生存率为57.9%。结论:鼻中隔恶性肿瘤鼻内镜下手术有一定的适应证,手术深浅层次的选择与手术安全缘的掌握具有同等重要的临床意义。
OBJECTIVE: To study the level of operation in nasal endoscopic sinus surgery. Methods: Nineteen patients with nasal septum malignant tumors undergoing endoscopic sinus surgery were divided into three groups according to tumor size, location, infiltration degree and exploration of surgical procedure. The first group (6 cases) performed the first level of surgical treatment, the second group (9 cases) performed the second level of surgery and some patients plus radiotherapy, the third group (4 cases) performed the third level of surgery and all the patients plus radiotherapy. Results: In group 1, there were 4 cases without tumor and 2 cases with local recurrence. In group 2, there were 5 cases without tumor, 2 cases with local recurrence, 1 case with local metastasis and 1 case died. There were 2 cases without tumor in group 3 1 case of local recurrence and 1 case of local metastasis. There was no significant difference in curative effect between the three groups (P> 0.05). The 5-year survival rate of all patients was 94.7%, and the 5-year disease-free survival rate was 57.9%. Conclusion: Nasal endoscopic sinus surgery under endoscopic surgery have some indications, the choice of surgical depth and surgical margin of safety has the same clinical significance.