修正性鼻内镜手术并中鼻甲切除系统治疗难治性鼻息肉鼻窦炎  

Clinical research on revision endoscopic sinus surgery with middle turbinate resection comprehensive treatment of refractory sinusitis and nasal polyps

作　　者：戴俊[1,2] 怀德 徐敏[1,3] 王海旭[1,2] 殷敏[4] 程雷[4] 曹影[1,2] 汪守峰[1,2] 宋红毛[1,2] 张学文[1,2] 别同武[1,2] 

机构地区：[1]徐州医学院附属淮安医院 [2]江苏省淮安市第二人民医院耳鼻咽喉科,江苏淮安223002 [3]江苏省淮安市第二人民医院影像科,江苏淮安223002 [4]南京医科大学第一附属医院耳鼻咽喉科,210029

出　　处：《中华临床医师杂志（电子版）》2015年第16期50-54,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：江苏省淮安市科研课题(HA2013032)

摘　　要：目的研究分析修正性鼻内镜手术并中鼻甲切除为主系统治疗难治性鼻息肉鼻窦炎的方法、效果、价值等。方法回顾分析2012年2月至2015年3月间收治的182例既往多次手术及药物治疗无效并经CT及鼻内镜检查确诊的难治性鼻息肉鼻窦炎患者,根据手术方法等不同,随机分为治疗组和对照组,每组各91例患者,两组患者在性别、年龄、病程、鼻部疾病类型、合并疾病、鼻腔情况、既往手术史等一般资料比较,差异无统计学意义(P>0.05),治疗组修正性鼻内镜手术加中鼻甲切除、充分围手术期处理、规范随访等综合治疗,对照组常规手术方法治疗,术后随访6个月,比较两组的有效率、并发症及复发情况等指标。结果随访6个月后,治疗组总有效率为90.11%,对照组总有效率为72.53%,差异有统计学意义(P<0.05);治疗组在并发症发生率和复发率方面均低于对照组,差异有统计学意义(P<0.05)。结论修正性鼻内镜手术并中鼻甲切除加上围手术期充分准备、规范随访等系统治疗难治性鼻息肉鼻窦炎效果较为满意,有一定的临床应用价值。Objective To investigate the correction method, endoscopic sinus operation with middle turbinate resection comprehensive treatment of refractory nasal polyps sinusitis effect, value etc. Methods Reviewed 182 eases of previous analysis of February 2012-March 2015 whose multiple operation and drug treatment is invalid and confirmed refractory nasal polyps sinusitis by CT and endoscopic examination, according to the operation method, it will be randomly divided into observation group and control group, each group had 91 patients, two groups in gender, age the course of disease, type of disease, nasal, complicating diseases, nasal cavity, operation history comparison of general data, had no significant difference （P〉0.05）, the observation group was performed with revision endoscopic sinus operation with middle turbinate resection, full operation period processing, standardized follow-up and other comprehensive treatment, the control group was conventional treatment of operation method, postoperatively followed-up 6 months, compared the efficiency in two groups, complications and recurrence and efficiency. Results ARer 6 months of follow-up, in the observation group the total effective rate was 90.11%, no efficiency was 9.89%, in control group the total effective rate was 72.53%, no efficiency was 27.47%, the difference was statistically significant （P〈0.05）; in the observation group the incidence of complications and the recurrence rate was lower than the control group, the difference was statistically significant （P〈0.05）. Conclusion Application of modified nasal endoscopic operation with middle turbinate resection of peri operation period, fully ready, standardized follow-up comprehensive treatment of refiactory nasal polyps sinusitis is effective, is worthy of clinical application.

关 键 词：鼻息肉 鼻窦炎 修正性 鼻内镜手术 中鼻甲 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]