鼻窦炎患者鼻窦球囊扩张术后再手术的相关因素分析  

Related factors of reoperation after sinus balloon dilatation for patients with sinusitis

作　　者：管恩玲 杨华 侯克强 Guan Enling;Yang Hua;Hou Keqiang(Huangdao District Hospital of Traditional Chinese Medicine,Qingdao 266500,China)

机构地区：[1]青岛市黄岛区中医医院,266500

出　　处：《国际医药卫生导报》2020年第14期2072-2075,2113,共5页International Medicine and Health Guidance News

摘　　要：目的研究与鼻窦炎患者行球囊扩张术后需再次行内窥镜鼻窦手术相关的影响因素。方法选取2014年6月至2017年6月于本院耳鼻喉科因鼻窦炎接受鼻窦球囊扩张术治疗的患者181例为研究对象,经2年随访,其中18例失访,需再次行内窥镜鼻窦手术患者共32例,为再手术组,余131例为对照组;比较两组患者临床资料、临床表现、内窥镜及影像学检查指标等情况进行回归分析。结果两组患者性别、病程、年龄、头痛/偏头痛、哮喘、鼻塞比较,差异均无统计学意义(均P>0.05);两组患者吸烟史、内窥镜手术史、变应性鼻炎比较,差异均有统计学意义(均P<0.05);两组患者内镜下流脓、黏连、金葡菌感染情况及Lund-Kennedy评分比较,差异均无统计学意义(均P>0.05);再手术组患者息肉、革兰氏阴性菌感染为87.50%、81.25%,高于对照组64.12%、61.07%,差异均有统计学意义(均P<0.05);两组患者Lund-Mackay评分、病灶分布间比较,差异均无统计学意义(均P>0.05);再手术组鼻中隔偏曲、骨质增生、窦内高密度、窦中重度浑浊分别为65.63%、53.13%、50.00%、62.50%,均高于对照组37.40%、32.06%、26.72%、41.98%,差异均有统计学意义(均P<0.05);logistic回归分析显示,变应性鼻炎(OR=5.500,P=0.001)、鼻中隔偏曲(OR=5.062,P=0.010)、骨质增生(OR=6.317,P=0.015)均为再手术的危险因素。结论变应性鼻炎、鼻中隔偏曲、骨质增生为鼻窦炎患者球囊扩张术后再手术的相关危险因素。Objective To investigate the influencing factors of the need for endoscopic sinus surgery after balloon dilation for patients with sinusitis.Methods A total of 181 patients who received sinus balloon dilatation due to sinusitis in the department of otolaryngology of our hospital from June,2014 to June,2017 were selected as study objects.After 2 years’follow-up,18 cases were lost to follow-up,and a total of 32 cases needing endoscopic sinus surgery were in the reoperation group,while the remaining 131 cases were in the control group.The clinical data,clinical manifestations,endoscopy and imaging indicators of the two groups were compared;and regression analysis was performed.Results There were no statistical differences between the two groups in gender,disease course,age,headache or migraine,asthma,and nasal congestion(all P>0.05),but were in smoking history,endoscopic surgery history,and allergic dermatitis(all P<0.05).There were no statistical differences in endoscopic pus,adhesion,s.aureus infection,and Lund-Kennedy score between the two groups(all P>0.05).The incidences of polyps and gram-negative bacteria infection were higher in the reoperation group than in the control group(87.50%vs.64.12%and 81.25%vs.61.07%;both P<0.05).There were no statistical differences in Lund-Mackay score and lesion distribution between the two groups(both P>0.05).The incidences of septal deviation,hyperrostosis,high sinus density,and severe sinus turbidity were 65.63%,53.13%,50.00%,and 62.50%in the reoperation group,and were 37.40%,32.06%,26.72%,and 41.98%in the control group(all P<0.05).Logistic regression analysis showed that allergic rhinitis(OR=5.500,P=0.001),septal deviation(OR=5.062,P=0.010),and hyperostosis(OR=6.317,P=0.015)were risk factors for reoperation.Conclusion Allergic rhinitis,septal deviation and hyperostosis are the related risk factors for reoperation after balloon dilation for patients with sinusitis.

关 键 词：鼻窦球囊扩张术 内窥镜检查 鼻窦炎 鼻窦CT logistics回归分析 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]