山东大学耳鼻喉眼学报 ›› 2026, Vol. 40 ›› Issue (4): 28-36.doi: 10.6040/j.issn.1673-3770.0.2026.009
叶任静,杜雅妮,罗卓丁,史雅文,吴中飞,殷敏
YE Renjing, DU Yani, LUO Zhuoding, SHI Yawen, WU Zhongfei, YIN Min
摘要: 目的 分析外鼻肿物的临床及病理学特征,探讨不同病理类型、发病部位及修复方式与预后的关系,为规范化诊治及综合修复提供参考。 方法 回顾性收集江苏省人民医院耳鼻咽喉头颈外科自2019年1月1日至2025年12月1日收治并经病理证实的外鼻肿物患者资料,记录性别、年龄、病变性质(非肿瘤性病变、良性肿瘤、恶性肿瘤)、病理类型、发病部位、手术方式及术后修复方法,并结合随访资料进行预后分析。采用χ2检验、Kruskal-Wallis检验及Mann-Whitney U检验等统计学方法进行组间比较。 结果 本组共纳入外鼻肿物患者129例,其中男69例、女60例,男∶女为1.15∶1.00,年龄6~99(60.02±16.73)岁。非肿瘤性病变14例、良性肿瘤32例、恶性肿瘤83例。三组间性别构成差异有统计学意义(χ2=8.22,P=0.016);非肿瘤、良性与恶性三组年龄分布差异亦具有统计学意义(χ2=23.12, P<0.001),且恶性肿瘤患者年龄高于良性肿瘤(P<0.001)。良性肿瘤以皮内痣最常见(43.8%),恶性肿瘤则以表皮来源的基底细胞癌和鳞状细胞癌为主(分别占63.9%和26.5%)。整体上外鼻肿物多发生于鼻翼和鼻背等暴露部位,发病部位与肿瘤良恶性之间相关性差异无统计学意义(P>0.05)。所有病例均行肿物完整切除,根据缺损范围和立体结构选择对位缝合、鼻唇沟瓣、额瓣、临近皮瓣等多种修复方式。 结论 本组外鼻肿物以老年患者及恶性上皮性肿瘤为主要构成,发病部位多位于鼻翼与鼻背。对疑似恶性或边界不清病变应充分切除并联合立体重建与功能、美观兼顾的皮瓣修复;特殊类型如淋巴瘤及软组织肿瘤需提高警惕,及时行系统评估及综合治疗。
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