發(fā)布時間：2018-11-17 20:26

【摘要】：目的 探討外耳道、中耳惡性腫瘤的臨床表現(xiàn)、診斷要點及治療原則和方法,以期提高患者生存率,改善生活質(zhì)量。 方法 回顧性分析2000年1月-2009年1月鄭州大學(xué)第一附屬醫(yī)院耳鼻咽喉頭頸外科收治并經(jīng)病理證實的資料完整的外耳道、中耳惡性腫瘤30例,分析內(nèi)容包括臨床表現(xiàn)、病理類型、影像學(xué)表現(xiàn)、頸部淋巴結(jié)B超及其他輔助檢查,不同臨床分期及不同治療方案的預(yù)后,定期隨訪情況等。在定期隨訪期間做術(shù)腔的清理、復(fù)查CT或MRI。 結(jié)果 全組隨訪3年累積生存率為77%,5年累積生存率為58.4%,復(fù)發(fā)多發(fā)生在2-5年內(nèi)。按still系統(tǒng),在30例患者中T1期6例,T2期15例,T3期9例,早期診治的患者累積生存較高,預(yù)后較好。單純手術(shù)治療易復(fù)發(fā)。 結(jié)論 1外耳道、中耳惡性腫瘤以鱗狀細(xì)胞癌和腺樣囊性癌多見。 2臨床分期較早的患者累積生存率較高,針對不同病例選擇合適的治療方案,早期診斷,早期治療是提高5年累積生存率的關(guān)鍵。 3以手術(shù)為主結(jié)合放療和/或化療的綜合治療是本病的最佳治療方案。 4術(shù)后長期規(guī)范隨訪,建立長期隨訪質(zhì)量,便于提高治療效果和盡早發(fā)現(xiàn)復(fù)發(fā)的患者。
[Abstract]:Objective to investigate the clinical manifestation, diagnosis and treatment of malignant tumors of external auditory canal and middle ear in order to improve the survival rate and quality of life. Methods from January 2000 to January 2009, 30 cases of external auditory canal and middle ear malignant tumor treated in Department of Otorhinolaryngology and head and neck surgery of the first affiliated Hospital of Zhengzhou University were retrospectively analyzed. Pathological types, imaging findings, cervical lymph node B ultrasound and other auxiliary examination, different clinical stages and treatment of the prognosis, regular follow-up and so on. Perform surgical cavity cleaning during regular follow-up and review CT or MRI. Results the 3-year cumulative survival rate and 5-year cumulative survival rate were 77 and 58.4 respectively. Recurrence occurred within 2-5 years. According to still system, there were 6 cases of T1 stage, 15 cases of T2 stage and 9 cases of T3 stage in 30 cases. The patients with early diagnosis and treatment had higher cumulative survival and better prognosis. Simple surgical treatment is easy to relapse. Conclusion 1 squamous cell carcinoma and adenoid cystic carcinoma are the most common malignant tumors in external auditory canal and middle ear. (2) the cumulative survival rate of the patients with earlier clinical stages was higher. The key to improve the 5-year cumulative survival rate was to select appropriate treatment schemes for different cases and to make early diagnosis and early treatment. 3 combined surgery combined with radiotherapy and / or chemotherapy is the best treatment for this disease. (4) long term standard follow-up and quality of long term follow-up were established to improve the effect of treatment and to detect recurrence as soon as possible.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R764

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