保留或重塑与切除钩突对鼻内镜术后鼻窦粘膜转归影响的对比研究  

作　　者：吕凌燕[1] 王玉芝[1] 王兴杰[1] 曲吉占 

机构地区：[1]聊城市第二人民医院山东聊城252600

出　　处：《特别健康（下）》2014年第3期30-30,共1页SPECIAL HEALTH

摘　　要：目的：比较鼻内镜手术中保留或重塑钩突与全部切钩突对鼻内镜术后术腔黏膜转归的影响。方法：将46例慢性鼻窦炎患者作为临床观察对象。每例患者左侧鼻腔为实验组，右侧鼻腔为对照组。实验组采用保留或重塑钩突的鼻窦内镜手术，对照组行经典鼻内镜手术。手术后按照主观症状恢复情况和鼻内镜下局部状态评价鼻腔黏膜转归情况进行评定。结果：全部患者均随访1年以上。治愈1试验组40例（86．95％）。对照组38例（82．60％）。好转t试验组6例（13．04％）。对照组8例（17．39％）。两组治愈率无明显统计学差异。术后1年内鼻内镜检查术腔黏膜情况，试验组和对照组筛窦及或中鼻道黏膜囊泡样内芽生长分别为1例和5例，黏膜患肉样水肿分别为1例和7例，对照组炎症复发1例。实验组和对照组术腔上皮化时间分别为8—10周和10—14周．2组差异有统计学意义（P〈0．05）。结论；保留或重塑钩突符合鼻腔生理学特点，减少了术腔粘膜转归阶段发生新生病变可能。对鼻腔、鼻窦黏膜的良性转归有积极的影响，减少了鼻窦黏膜炎症的复发机会。Objective; To compare the impact of sinus mucosa outcome by preservation/reconstruction and ablation of uncinate process in endoscopic sinus surgery. Methods ： Thirty--six patients with chronic rhinosinusitis（CRS） were selected as clinical subjects. For each patient,the left aide was selected to preserve or reconstruct the shape of uncinate process by nasal sinus opening surgery,the right was received traditional functional endoscopic sinus surgery（FESS） as control, The impact of sinus mucosa outcome after surgery was evaluated according to the restoration of symptoms and local state under endoscope. Reaultsz By the end of one year following treatment, 40cases were cured,6 eases were effective in TG,and38 cases were cured,8 eases were effective in CG. 12 months after the operation of nasal mucosa endoscopy, the test group and the control group of ethmoid sinus and the middle nasal meatus cystoid edema were 1 case and 5 cases respectively, with a significant difference between 2 groups （P〈0. 05）. Conclusion sThe FESS retained/remolded uneinate process retains the normal structure of nasal cavity,is more suitable to the Characteristics of nasal airflow. Reduced the recurrence of sinus mueosal inflammation opportunity.

关 键 词：钩突 重塑 鼻内镜术 粘膜 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]