鼻内窥镜下改良的鼻丘径路额窦开放术对慢性额窦炎的疗效  

Effect of Modified Nasal Hill Approach Frontal Sinus Opening Surgery under Nasal Endoscope on Chronic Frontal Sinusitis

作　　者：閣汉东 熊金梅 GE Handong;XIONG Jinmei(Suizhou Zengdu Hospital,Suizhou 441300,China)

机构地区：[1]湖北省随州市曾都医院,湖北随州441300

出　　处：《中国医学创新》2019年第5期140-143,共4页Medical Innovation of China

摘　　要：目的:探讨鼻内窥镜下改良的鼻丘径路额窦开放术治疗慢性额窦炎的临床效果。方法:选取本院耳鼻喉科2017年1-12月收治的慢性额窦炎患者88例作为研究对象,采用随机双盲法将其分为对照组和观察组,各44例。对照组行鼻内窥镜下常规入路额窦开放术,观察组行改良的鼻丘径路额窦开放术,比较两组手术时间、术中出血量、临床疗效、治疗前后的嗅觉功能变化情况、生活质量评分以及术后随访6个月的疾病复发情况。结果:观察组手术时间及术中出血量均明显低于对照组,差异均有统计学意义(P<0.05)。观察组的临床总有效率为95.45%(42/44),对照组为88.64%(39/44),两组临床总有效率比较,差异无统计学意义(X^2=1.397,P=0.237)。术后随访6个月,观察组的疾病复发率为2.27%(1/44)明显低于对照组的15.91%(7/44),差异有统计学意义(X^2=4.950,P=0.026)。治疗后2、6、8周,两组的平均嗅觉阈值与治疗前比较均明显降低,且观察组均明显低于对照组,差异均有统计学意义(P<0.05)。治疗后8周,两组量表中20个条目及最重要的5个条目评分与治疗前比较均明显降低,且观察组均明显低于对照组,差异均有统计学意义(P<0.05)。结论:相较于常规入路额窦开放术,鼻内窥镜下改良的鼻丘径路额窦开放术可显著减少患者手术时间及术中出血量,降低术后复发率,提高患者生活质量,可在慢性额窦炎的临床治疗中进一步推广应用。Objective:To evaluate the clinical effect of modified nasal hill approach frontal sinus opening surgery under nasal endoscope in the treatment of chronic frontal sinusitis.Method:A total of 88 patients with chronic frontal sinusitis admitted in ENT department of our hospital from January to December 2017 were selected as the research objects.They were divided into control group and observation group by random double blind method,44 cases in each group.The control group was treated with frontal sinus opening surgery by routine approach under nasal endoscope,the observation group was treated with modified frontal sinus opening surgery by nasal hill approach.The operation time,intraoperative bleeding volume,clinical efficacy,changes of olfactory function,quality of life score before and after treatment and disease recurrence after follow-up 6 months between the two groups were compared.Result:The operation time and intraoperative bleeding volume in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The clinical total effective rate was 95.45%(42/44)in the observation group and 88.64%(39/44)in the control group,there was no significant difference in the clinical total effective rate between the two groups(χ^2=1.397,P=0.237).After follow-up 6 months,the disease recurrence rate of the observation group was 2.27%(1/44),which was significantly lower than 15.91%(7/44)in the control group,the difference was statistically significant(χ^2=4.950,P=0.026).After treatment 2,6 and 8 weeks,the average olfactory threshold of the two groups were significantly lower than those before treatment,and the observation group were significantly lower than those of the control group,the differences were statistically significant(P<0.05).After treatment 8 weeks,the scores of 20 items and the most important 5 items in the scale of the two groups were significantly lower than those before treatment,and the observation group were significantly lower than those

关 键 词：慢性额窦炎 鼻内窥镜 改良的鼻丘径路额窦开放术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]