内镜鼻窦术后鼻-鼻窦炎症状转归规律研究  

Variation Rule of Chronic Rhinosinusitis Symptoms Undergoing Endoscopic Sinus Surgery

作　　者：陈东[1] 王珮华[1] 王钟颖[1] 汪涛[1] 汤君彦[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院耳鼻咽喉科,上海市200011

出　　处：《中国全科医学》2006年第15期1239-1241,共3页Chinese General Practice

摘　　要：目的探讨内镜鼻窦术后鼻-鼻窦炎症状的转归规律。方法视随访的情况将187例患者分为随访组(150例)和对照组(37例),所有患者就头痛、鼻塞、流涕、面部疼痛(胀感)和嗅觉障碍等5个症状,分别在术前、术后2周、1个月、3个月和6个月时进行自主评分,计算术后各个时间段症状改善值,同时记录术后复发和不同临床分型患者术后术腔出现芽孢或囊泡的情况。结果流涕、面部疼痛(胀感)和嗅觉障碍症状转归良好,相邻时间段间症状改善率间差异有显著性意义(P<0.05),头痛、鼻塞症状在术后1个月起,改善不再明显(P>0.05);术后3个月两组症状改善值,除流涕症状外,其余差异均有显著性意义(P<0.05);随访组(2/150),对照组(7/37)复发率间差异有显著性意义(P<0.05);不同临床分型患者术后术腔出现芽孢或囊泡的情况间差异有显著性意义(P<0.05)。结论内镜鼻窦术后鼻-鼻窦炎患者的流涕、面部疼痛(胀感)和嗅觉障碍症状转归理想,头痛、鼻塞症状转归较好。术后随访积极干预,对症状转归有积极意义,是改善症状和减少复发的必要措施。Objective To determine the variation rule of chronic rhinosinusitis （CRS） symptoms undergoing endoscopic sinus surgery （ESS）. Methods The 187 patients with chronic rhinosinusitis were classified as follow - up group and control group according to the conditions in follow - up. All patients were evaluated in the five respects of rhinosinusitis symptoms including facial pressure （ache）, headache, nasal obstruction, rhinorrhea, and hyposmia preoperatively, and 2 weeks, 1 month, 3 months and 6 months after ESS. Data of the two groups were analyzed and compared in the symptom score changes and effective degrees. Results In improvement, except for rhinorrhea, there was a significant difference between the two group （ P 〈0. 05）. As for relapse of symptoms, there was a significant difference between the follow - up group （2/150） and control group （7/37） （ P 〈0.05）; In postoperative gemmatation and vesiculation in the operation site, there was a significant difference among the three types clinically classified （ P 〈 0. 05 ）. Conclusion Endoscopic sinus surgery can significantly relieve symptoms of facial pressure （ ache）, headache, nasal obstruction, rhinorrhea and hyposmia associated with CRS. However, many patients undergoing ESS require continued intense medical management of their chronic rhinosinusitis.

关 键 词：鼻窦炎 内镜检查 预后 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]