内镜手术治疗慢性鼻-鼻窦炎伴与不伴鼻息肉的疗效比较  

Comparison of therapeutic effects between chronic rhino-sinusitis complicated with and without nasal polypsis treated by endoscopic surgery

作　　者：李琪[1] 韩泽利 袁伟[1] 白杨[1] 张学渊[1] 

机构地区：[1]第三军医大学西南医院耳鼻喉科,重庆400038 [2]解放军304医院耳鼻喉科

出　　处：《西南国防医药》2012年第12期1312-1315,共4页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨鼻内镜手术治疗伴与不伴鼻息肉(NP)的慢性鼻-鼻窦炎(CRS)患者的不同疗效。方法鼻内镜手术治疗伴NP的CRS患者38例(NP组),不伴NP的CRS患者42例(sNP组),比较两组患者术后并发症、主观症状评分(VAS)、CT检查评分及内镜检查评分、术后复发情况。结果 NP组并发症发生率(26.3%)与sNP组(19.0%)相比无显著差异(χ2=0.604;P>0.05)。术前NP组嗅觉障碍评分显著高于sNP组(F=5.517,P<0.05),其他症状评分均无显著差异。术后1 w,NP组除鼻塞外各症状评分均分别高于sNP组(P<0.05);术后1个月,NP组各症状评分仍显著高于sNP组(P<0.05);术后3个月,两组症状均基本消失,相比无显著差异。NP组患者术前CT评分及内镜评分均显著高于sNP组(P<0.01),术后1 w、1个月,NP组仍显著高于sNP组(P<0.01);术后3个月,两组患者无显著差异。NP组术后复发率为21.1%,显著高于sNP组(4.7%)(χ2=4.841;P<0.05)。结论伴有NP的CRS患者,鼻内镜术后较不伴有NP的患者恢复慢,并且复发率较高。Objective To discuss the different therapeutic effects of endoscopic surgery on chronic rhino-sinusitis（CRS） complicated with and without nasal polypsis（NP）.Methods Thirty eight patients with CRS complicated with NP（NP group） and 42 CRS patients without NP（sNP group） all received the endoscopic surgery.Comparison was made in patients＇ postoperative complications,subjective symptom scores（SSS）,CT and endoscopic examination scores,and post-operative recurrence.Results There was no significant difference in the incidence of complication between NP group（26.3%） and sNP group（19.0%）（χ2=0.604,P0.05）.Before the operation,the dysosmia score of NP group was significantly higher than that of sNP group（F=5.517,P0.05）,but there was no significant difference in the scores for other symptoms between the two groups.One week after the operation,the scores for all the symptoms except nasal obstruction in NP group were higher than those in sNP group（P0.05）.One month after the operation,the scores for all the symptoms of NP group were still higher than those of sNP group（P0.05）.Three months after the operation,the symptoms disappeared,and there was no significant difference between the two groups.The CT and endoscopic scores of NP group were all higher than those of sNP group before the operation（P0.01）.One week and one month after the operation,those of NP group were still higher（P0.01）.Three months after the operation,there was no significant difference between the two groups.The recurrence rate in NP group was 21.1%,which was significantly higher than that in sNP group（4.7%）（χ2=4.841,P0.05）.Conclusion Compared with CRS patients without NP,those complicated with NP had slower recovery and higher recurrence rate.

关 键 词：鼻内镜 慢性鼻-鼻窦炎 鼻息肉 并发症 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]