目的 探讨基层医院内镜下治疗鼻腔-鼻窦恶性肿瘤的体会.方法回顾性分析本科2007年7月-2010年7月鼻内镜下外科治疗的9例鼻腔-鼻窦恶性肿瘤患者的临床资料.9例患者的病理学类型分别为:内翻性乳头状瘤恶变2例,上颌窦鳞状上皮细胞癌3例,腺样囊性癌3例,鼻中隔乳头状腺癌1例.结果 9例患者均在内镜或内镜辅助下手术治疗,肿瘤全部或大部分切除,术后辅以放疗.随访0.5~4.0年,术后3~10个月复发于上级医院再次行鼻内镜手术治疗4例,术后半年死亡1例,术后随访至今未复发4例.结论 在基层医院,要以完全切除肿瘤为原则,谨慎选择病例,逐步开展鼻内镜下的鼻腔-鼻窦恶性肿瘤的手术.%Objective To investigate the feasibility of endoscopic surgeries for nasal cavity - sinus malignancies in primary hospitals. Methods A retrospective analysis was performed on the data of 9 patients with nasal cavity - sinus malignancies, having received endoscopic surgeries in Department of Otolaryngology from July 2007 to July 2010. The pathological types were inverted papilloma with malignant transformation ( 2 cases ), maxillary sinus squamous cell carcinoma ( 3 cases ), adenoid cystic carcinoma ( 3 cases ), nasal septum papillary adenocarcinoma ( 1 case ). Results All 9 patients were given endoscopic surgeries with tumors resected totally or subtotally, followed by radiotherapy. Follow - up lasted 6 months to 4 years. Four had recurrence 3 ~ 10 months after operation and received another endoscopic surgery in higher - level hospitals, 1 died at the 6th months, no recurrence noted in 4 up to now. Conclusion In primary hospitals, patients should be chosen carefully and endoscopic surgeries performed gradually, based on total resection of tumors.
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