脱细胞真皮基质覆盖鼻腔鼻窦良性肿瘤切除术后术腔的临床疗效观察

doi:10.6040/j.issn.1673-3770.0.2020.379

摘要/Abstract

摘要： 目的探讨应用脱细胞真皮基质(ADM)在鼻腔鼻窦良性肿瘤切除术后黏膜形态恢复及上皮化情况,比较并分析患者主观症状评分及黏膜鼻内镜下评分,评价脱细胞真皮基质在促进术后鼻黏膜功能修复及上皮化中的应用价值,为改善鼻内镜术后恢复提供新的思路及方法。方法鼻腔鼻窦肿瘤患者32例,分别统计实验组(使用ADM)与对照组(未使用ADM)患者术前及术后1、2、4、12周的视觉模拟量表评分(VAS)和Lund-Kennedy评分(LKES),比较两组临床疗效,并通过上皮化率对两组患者在4、8、12周上皮化情况进行比较。结果术后2周开始,实验组的黏膜恢复情况优于对照组(P<0.05),对单独的体征来看,结痂情况在术后1~4周,实验组的LKES明显低于对照组(P<0.05);术后12周,实验组的瘢痕LKES明显低于对照组(P<0.05);术后4~12周的上皮化率实验组明显高于对照组(P<0.05)。术后均未出现不良反应。结论鼻腔鼻窦良性肿瘤术区黏膜覆盖脱细胞真皮基质能有效的促进黏膜上皮化从而缩短黏膜上皮化时间,改善鼻腔黏膜结痂瘢痕等情况,改善患者主观症状,提高患者生活质量,值得临床应用。

关键词: 鼻腔鼻窦良性肿瘤, 脱细胞真皮基质, 修复, 上皮化, 疗效观察

Abstract: Objective This study aimed to observe and investigate the application of acellular dermal matrix in the nasal sinuses after resection of benign tumors of the nasal cavity and paranasal sinuses, mucosal morphology recovery, and epithelialization. It also compared and analyzed the patient's symptom scores and nasal endoscopy results for the mucous membrane, to evaluate the value of acellular dermal matrix in promoting functional repair and epithelialization of the postoperative nasal mucosa. Finally, it aimed to provide new ideas and methods of improving postoperative recovery of nasal endoscopy. Methods 32 Patients were randomly divided into the experimental group(with acellular dermal matrix)and the control group(without acellular dermal matrix). The Visual Analog Scale(VAS)score and Lund-Kennedy Score(LKES)at 1, 2, 4, and 12 weeks before and after surgery were determined for each of the two groups, and the clinical efficacy of the methods used in the two groups was compared. Results At 2 weeks after surgery, the recovery of the mucosa of the experimental group was significantly better than that of the control group(P<0.05). Regarding the separate signs, the LKES achieved by the experimental group was significantly lower than that achieved by the control group(P<0.05). At 12 weeks after surgery, the scar LKES of the experimental group was significantly lower than that of the control group(P<0.05). The rate of epithelialization in the experimental group was significantly higher than that in the control group(P<0.05). No complications occurred after the operation. The epithelialization rates were compared between the two groups at 4, 8, and 12 weeks. Conclusion Covering the acellular dermal matrix with mucosa in the operative area of benign tumors of the nasal cavity and paranasal sinuses resection can effectively promote the epithelialization of mucosa, accelerate the epithelialization, and improve the scab scar of the nasal mucosa, the symptoms of patients, and patients’ quality of life, which is worthy of clinical application.

Key words: Nasal sinuses benign tumor, Acellular dermal matrix, Repair, Epithelization, Observation of curative effect

中图分类号:

R765.9

金鑫,施磊,金梦园. 脱细胞真皮基质覆盖鼻腔鼻窦良性肿瘤切除术后术腔的临床疗效观察[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 17-22.

JIN Xin, SHI Lei, JIN Mengyuan. Application of decellularized dermal matrix after benign tumor resection in the nasal sinus[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 17-22.

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