改良鼻内镜下蝶窦开放术治疗真菌性蝶窦炎的疗效  

Efficacy and safety of modified nasal endoscopic sphenoidostomy and traditional surgery in the treatment of fungal sphenoid sinusitis

作　　者：王玲[1] 罗伟[1] 文科[1] WANG Ling;LUO Wei;WEN Ke(Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Chengdu Medical College,Chengdu,Sichuan 610500,China)

机构地区：[1]成都医学院第一附属医院耳鼻咽喉头颈外科

出　　处：《中国临床研究》2019年第5期654-656,660,共4页Chinese Journal of Clinical Research

摘　　要：目的观察改良鼻内镜下蝶窦开放术治疗真菌性蝶窦炎的疗效及安全性。方法回顾性分析2013年1月至2018年1月收治的78例真菌性蝶窦炎患者临床资料,根据治疗方式分为改良鼻内镜下蝶窦开放术组(A组,n=36)和传统手术组(B组,n=42)。观察两组手术情况和临床疗效,比较两组患者术后6个月时鼻黏膜症状(Lund-Kennedy评分)和鼻腔鼻窦改善情况[鼻腔鼻窦测试-20(SNOT-20)评分],及并发症发生情况。结果两组手术时间、术中出血量比较差异无统计学意义(P>0.05)。A组术毕至窦口上皮化时间显著短于B组[(35.31±5.17)dvs(42.59±9.51)d,t=4.472,P=0.000]。两组总有效率均100%,差异无统计学意义(P>0.05);A组治愈率高于B组(91.67%vs69.05%,χ^2=6.083,P=0.014)。术后6个月时,A组Lund-Kennedy、SNOT-20评分均显著低于B组(P<0.01)。两组术后并发症总发生率比较差异无统计学意义(P>0.05)。结论改良鼻内镜下蝶窦开放术可显著缩短患者术后恢复时间,提高治愈率,减轻鼻黏膜症状,提升生活质量,且安全性良好,较传统术式更具优势。Objective To observe the efficacy and safety of modified nasal endoscopic sphenoidostomyversus traditional surgery in the treatment of fungal sphenoid sinusitis.Methods The clinical data of 78 patients with fungal sphenoid sinusitis admitted from January 2013 to January 2018 were retrospectively analyzed.According to the treatment methods, they were divided intomodified nasal endoscopic sphenoidostomy group ( group A, n = 36) and traditional surgery group ( group B,n = 42).The operation and clinical effect were observed.The nasal mucosal symptoms ( Lund-Kennedy score) and the improvement of nasal cavity and sinus [sino-nasal outcome test-20 ( SNOT-20)] were compared at 6 months after operation between two groups.The complications were recorded and compared.Results There were no significant differences in operative time, intraoperative blood loss and total effective rate( 100% in both groups) between two groups ( all P > 0.05).The epithelialization time of sinus ostium in group A was significantly shorter than that in group B [( 35.31 ± 5.17) d vs ( 42.59 ± 9.51) d, t = 4.472, P = 0.000], and the cure rate was statistically higher than that in group B( 91.67% vs 69.05%,χ^2 = 6.083, P = 0.014).At 6 months after operation, the scores of Lund-Kennedy and SNOT-20 in group A were significantly lower than those in group B( P < 0.01).There was no significant difference in the incidence of postoperative complications between two groups ( P > 0.05 ).Conclusions Modified nasal endoscopic sphenoidostomy can significantly shorten the postoperative recovery time, increase the cure rate, reduce the nasal mucosasymptoms,improve the quality of life and have good safety in the treatment offungal sphenoid sinusitis.It offers more advantages over traditional surgery.

关 键 词：改良鼻内镜下蝶窦开放术 真菌性蝶窦炎 鼻黏膜症状 生活质量 安全性 

分 类 号：R765.44[医药卫生—耳鼻咽喉科]