慢性鼻-鼻窦炎伴鼻息肉患者鼻内镜术后鼻息肉复发的影响因素  

Influencing Factors of Recurrence of Nasal Polyps in Patients with Chronic Rhinosinusitis with Nasal Polyps after Endoscopic Sinus Surgery

作　　者：潘泽如 陈红先 詹淑洁 PAN Zeru;CHEN Hongxian;ZHAN Shujie(Department of Otolaryngology,Zhuhai People′s Hospital(Zhuhai Hospital Affiliated to Jinan University),Zhuhai 519000,China)

机构地区：[1]珠海市人民医院(暨南大学附属珠海医院)耳鼻咽喉科,广东珠海519000

出　　处：《医学综述》2021年第13期2695-2699,共5页Medical Recapitulate

摘　　要：目的观察慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)患者鼻内镜术后鼻息肉复发情况,分析复发的影响因素。方法选择2016年8月至2018年8月珠海市人民医院收治的615例完成鼻内镜手术治疗的CRSwNP患者为研究对象,随访2年统计患者鼻息肉复发情况,自制调查问卷对复发和未复发患者进行调查,记录患者的相关资料,经单因素与多因素Logistic回归分析CRSwNP患者鼻内镜术后鼻息肉复发的影响因素。结果615例完成鼻内镜手术治疗的CRSwNP患者随访2年发现,83例患者鼻息肉复发,复发率为13.50%。复发组患者多发性鼻息肉、术后感染、吸烟的比例高于未复发组[53.01%(44/83)比11.84%(63/532)、28.92%(24/83)比3.95%(21/532)、57.83%(48/83)比21.05%(112/532)](P<0.01),复发组嗜酸粒细胞计数高于未复发组[(0.48±0.12)×10^(9)/L比(0.38±0.06)×10^(9)/L](P<0.01)。多因素Logistic回归分析结果显示,多发性鼻息肉、嗜酸粒细胞升高、术后感染、吸烟是CRSwNP患者鼻内镜术后鼻息肉复发的影响因素(P<0.01)。结论CRSwNP患者鼻内镜术后鼻息肉复发率较高,可能与多发性鼻息肉、嗜酸粒细胞百分比值高、术后感染、吸烟等因素有关,临床应重视上述因素并及时对伴有上述因素的患者实施干预。Objective To observe the recurrence of nasal polyps in patients with chronic rhinosinusitis with nasal polyps(CRSwNP)after endoscopic sinus surgery,and to investigate the influencing factors of recurrence.Methods A total of 615 patients with CRSwNP who completed endoscopic sinus surgery treatment in Zhuhai People′s Hospital from Aug.2016 to Aug.2018 were included,after 2 year of follow-up,the recurrence of nasal polyps in patients was counted,a self-made questionnaire was used to investigate the patients with and without recurrence,and the relevant data of patients was recorded.By univariate and multivariate Logistic analysis,the influencing factors of the recurrence of nasal polyp in patients with CRSwNP after endoscopic sinus surgery were analyzed.Results Of the 615 patients,after 2 year of follow-up,nasal polyps recurred in 83 patients,and the recurrence rate of nasal polyps was 13.50%.The proportion of multiple nasal polyps,postoperative infection and smoking in the recurrent group were higher than those in the non-recurrent group[53.01%(44/83)vs 11.84%(63/532),28.92%(24/83)vs 3.95%(21/532),57.83%(48/83)vs 21.05%(112/532)](P<0.01),eosinophils was higher in the recurrent group than that in the non-recurrent group[(0.48±0.12)×10^(9)/L vs(0.38±0.06)×10^(9)/L](P<0.01).The results of multivariate Logistic regression analysis showed that multiple nasal polyps,high percentage of eosinophils,postoperative infection and smoking were the influencing factors of the recurrence(P<0.01).Conclusion The recurrence rate of nasal polyps in patients with CRSwNP after endoscopic sinus surgery is high,which may be related to factors such as multiple nasal polyps,high percentage of eosinophils,postoperative infection and smoking,so the above factors should be paid attention to clinically and corresponding intervention should be implemented in time.

关 键 词：慢性鼻-鼻窦炎伴鼻息肉 鼻内镜手术 复发 多发性鼻息肉 嗜酸粒细胞 感染 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]