经鼻内镜下鼻甲反转扩大下鼻道入路手术治疗上颌窦后鼻孔息肉的临床效果  

Clinical effect of inferior turbinate reversing extension through nasal endoscope inferior meatus approach on antrochoanal polyps

作　　者：谢佐君[1] 戴锋[1] 邱永亮[1] XIE Zuo-jun;DAI Feng;QIU Yong-liang(Department of Otolaryngology Head and Neck Surgery,Pingxiang People's Hospital,Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院耳鼻咽喉头颈外科

出　　处：《中国当代医药》2019年第30期57-60,共4页China Modern Medicine

基　　金：江西省萍乡市科技计划项目（2017NS006）

摘　　要：目的探讨经鼻内镜下鼻甲反转扩大下鼻道入路手术治疗上颌窦后鼻孔息肉(ACP)的临床效果。方法回顾性分析2017年5月~2018年5月我院收治的90例ACP患者的临床资料,根据手术方法不同分为对照组1组、对照组2组和研究组,每组各30例。对照组1组采用经鼻内镜上颌窦自然开口入路手术治疗;对照组2组采用经鼻内镜上颌窦自然开口入路联合下鼻道开窗入路手术治疗;研究组采用经鼻内镜上颌窦自然开口入路联合下鼻甲反转扩大下鼻道入路手术治疗,术后均随访1年。比较三组患者的临床疗效、视觉模拟量表(VAS)评分、鼻窦CT Lund-Mackay评分及复发率。结果研究组患者治疗后的总有效率(93.33%)高于对照组1组(66.67%)与对照组2组(73.33%),差异有统计学意义(P<0.05);三组患者治疗前的VAS评分及Lund-Mackay评分比较,差异无统计学意义(P>0.05);研究组患者治疗后的VAS、Lund-Mackay评分均低于对照组1组和对照组2组,差异有统计学意义(P<0.05);研究组患者的复发率(3.33%)低于对照组1组(23.33%)与对照组2组(20.00%),差异有统计学意义(P<0.05)。结论经鼻内镜下鼻甲反转扩大下鼻道入路手术治疗ACP具有较好的临床效果和较低的复发率,值得临床推广应用。Objective To explore clinical effect of inferior turbinate reversing extension through nasal endoscope inferior meatus approach on antrochoanal polyps(ACP).Methods Clinical data of 90 ACP patients who were admitted to our hospital from May 2017 to May 2018 were retrospectively analyzed.According to different surgical methods,they were divided into control group 1,control group 2 and study group,with 30 cases in each group.Control group 1 was treated with maxillary sinus natural ostium through nasal endoscope approach.Control group 2 was treated with maxillary sinus natural ostium through nasal endoscope approach combined with inferior nasal window approach.The study group was treated maxillary sinus natural ostium through nasal endoscope approach combined with inferior turbinate reversing extension through nasal approach.The patients were followed up for 1 year after surgery.The clinical curative effect,scores of visual analog scale(VAS),sinus CT Lund-Mackay score,and recurrence rate were compared among the three groups.Results The total effective rate after treatment of the study group(93.33%)was higher than that of control group 1(66.67%)and control group 2(73.33%),and the differences were statistically significant(P<0.05).Before treatment,there were no significant difference in VAS scores or Lund-Mackay scores among the three groups(P>0.05).After treatment,the scores of VAS and Lund-Mackay in study group were lower than those in control group 1 and control group 2,and the differences were statistically significant(P<0.05).The recurrence rate of study group(3.33%)was lower than that of control group 1(23.33%)and control group 2(20.00%),and the differences were statistically significant(P<0.05).Conclusion The clinical curative effect of inferior turbinate reversing extension through nasal endoscope inferior meatus approach is relatively better on ACP,and the recurrence rate is relatively lower.It is worthy of clinical popularization and application.

关 键 词：上颌窦后鼻息肉 经鼻内镜下鼻甲反转扩大下鼻道入路手术 下鼻甲 临床效果 

分 类 号：R765.25[医药卫生—耳鼻咽喉科]