鼻内镜下应用吸切器治疗放疗性后鼻孔闭锁的临床观察.docVIP

鼻内镜下应用吸切器治疗放疗性后鼻孔闭锁的临床观察 　　【摘要】 目的：探讨鼻内镜下应用吸切器治疗放疗性后鼻孔闭锁的临床观察。方法：对34例放疗性后鼻孔闭锁患者采用鼻内镜吸切器进行鼻孔成形手术治疗，术后加强鼻腔分泌物的清理。结果：34例放疗性后鼻孔闭锁患者采用鼻内镜吸切器手术均一次性手术成功；随访1～2年，31例患者后鼻孔恢复良好，鼻腔通气良好，边缘光滑无粘连，无肉芽增生形成。但有2例患者发生再闭锁，经检测为闭锁范围较大，甚至鼻咽腔发生闭锁，复查发现时均再次行鼻内镜吸切器手术，手术均成功治疗闭锁。结论：鼻内镜下应用吸切器治疗放疗性后鼻孔闭锁的疗效显著，值得临床进一步推广应用 【关键词】 鼻内镜； 吸切器； 放疗性后鼻孔闭锁 中图分类号 R766.3 文献标识码 B 文章编号 1674-6805（2015）20-0012-02 Clinical Observation on Effects of Transnasal Endoscopic Microdebrider System in the Treatment of Radiotherapeatical Choanal Atresia/QU Ye.//Chinese and Foreign Medical Research，2015，13（20）：12-13 【Abstract】 Objective： To investigate the clinical effects of transnasal endoscopic microdebrider system in the treatment of radiotherapeatical choanal atresia.Method： 34 patients with radiotherapeatical choanal atresia were treated by plastic procedure with transnasal endoscopic microdebrider system. And postoperative cleaning of nasal secretion was strengthened.Result： All of 34 patients received the operation successfully. After 1-2 years of follow-up， 31 patients had recovered. The nasal ventilation was good. And the edge of the nasal cavity was smooth， without adhesion or granulation hyperplasia. But 2 cases recurred atresia， which was larger in testing and even involved pharyngonasal cavity. These 2 cases were given surgery again with transnasal endoscopic microdebrider system. And the surgeries both successfully treated the atresia.Conclusion： Transnasal endoscopic microdebrider system has distinct curative effects in the treatment of radiotherapeatical choanal atresia， which is worth further application in clinic. 【Key words】 Nasal endoscope； Shaver system； Radiotherapeatical choanal atresia First-authors address：Cancer Hospital of Xiangxi Autonomous Prefecture， Jishou 416000，China doi：10.14033/j.cnki.cfmr.2015.20.006 后鼻孔闭锁是鼻咽癌患者放疗后常见的并发症之一，目前唯一的治疗方法为扩大闭锁处后鼻孔或重新造口[1-2]。传统的手术方法入路包括鼻中隔、腭进路、鼻进路、上颌窦进路等，但由于径路复杂，视野狭窄，导致损伤面积较大，加重了患者痛苦，愈合困难[3-4]。随着微创技术的发展，鼻内镜技术逐步成熟，在鼻咽科得到广泛的运用。故本研究采用鼻内镜下应用吸切器