鼻内镜手术联合围手术期治疗对不同临床表型慢性鼻-鼻窦炎的疗效观察  

To analyze the clinical efficacy of endoscopic sinus surgery and combined with perioperative surgery in the treatment of chronic rhinosinusitis with different clinical phenotypes

作　　者：连学攀 苑铁君[2] 黎秀莲[2] 李玲玉 孙大峰 LIAN Xuepan;YUAN Tiejun;LI Xiulian;LI Lingyu;SUN Dafeng(Department of Otolaryngology,Weifang Medical University,Weifang 261053,China;Department of Otolaryngology,Weifang People’s Hospital)

机构地区：[1]潍坊医学院耳鼻喉科学教研室,山东潍坊261053 [2]潍坊市人民医院耳鼻喉科

出　　处：《潍坊医学院学报》2021年第1期70-72,共3页Acta Academiae Medicinae Weifang

摘　　要：目的探讨鼻内镜手术及联合围手术治疗不同临床表型的慢性鼻-鼻窦炎(CRS)的临床疗效。方法选取收治的慢性鼻-鼻窦炎的患者200例,根据鼻腔病变组织病理结果分为嗜酸性粒细胞增多组(ECRS组)及非嗜酸性粒细胞增多组(non-ECRS组)。两组患者均先行3个月的非手术治疗。对未能治愈的患者行鼻内镜手术治疗。此外将ECRS组手术患者随机分为两组,一组患者直接行手术治疗,另外一组患者术前给予口服泼尼松2周。分析比较各种手术患者相应的手术相关指标以及临床疗效。结果经过3个月的非手术治疗后,ECRS组总有效率(3.75%)低于non-ECRS组(36.67%)(P<0.05)。在手术患者中ECRS组与non-ECRS组在手术相关指标以及临床疗效上也均存在统计学差异(P<0.05)。结论功能性鼻内镜手术联合围手术期治疗对non-ECRS患者疗效较好,对ECRS患者疗效较差,且ECRS患者术后易复发。Objective To analyze the clinical efficacy of endoscopic sinus surgery and combined with perioperative surgery in the treatment of chronic rhinosinusitis(CRS) with different clinical phenotypes.Methods Two hundred patients with chronic rhinosinusitis were selected and divided into eosinophilic group(ECRS group) and non eosinophilic group(non-ECRS group) according to the pathological results of nasal lesions.Two groups of patients were given 3 months of non-surgical treatment.The patients who were not cured were treated with endoscopic sinus surgery.The patients with ECRS group were randomly divided into two groups, one group was treated with surgery directly, the other group was given oral prednisone for 2 weeks before operation.The operation related indexes, postoperative complications, recurrence and curative effect were analyzed and compared.Results After 3 months of non-surgical treatment, the overall effective rate of ECRS group was 3.75%,which was significantly lower than that of non-ECRS group(36.67%).The curative effect of the two groups was statistically significant(P<0.05).The patients who failed to respond to non-surgical treatment were included in the surgical treatment.ECRS group and non-ECRS group were statistically significant in operation related indicators, surgical efficacy and recurrence(P<0.05).Conclusion Functional endoscopic sinus surgery combined with perioperative treatment is effective for patients with CRS without eosinophilia, it is poor for patients with CRS accompanied with eosinophilia, and patients with CRS with eosinophilia are more likely to relapse after surgery.

关 键 词：鼻-鼻窦炎 慢性 围手术治疗 鼻内镜手术 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]