慢性鼻-鼻窦炎伴鼻息肉鼻内镜术后复发调查及危险因素分析  

Recurrence of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery and its risk factors

作　　者：杨花荣[1] 陈影影 高英[1] 赵康[1] 王娜娜[1] 陈艳 YANG Huarong;CHEN Yingying;GAO Ying;ZHAO Kang;WANG Nana;CHEN Yan(Department of Otolaryngology,Affiliated Hospital of Yan’an University,Yan’an 716000,China)

机构地区：[1]延安大学附属医院耳鼻咽喉科,陕西延安716000

出　　处：《陕西医学杂志》2023年第2期184-187,共4页Shaanxi Medical Journal

基　　金：陕西省自然科学基础研究计划项目(2020JM-551);延安大学附属医院科技研究计划项目(2021PT-05)。

摘　　要：目的:调查延安大学附属医院2019-2021年慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)鼻内镜术后复发情况,并对复发的危险因素进行分析。方法:回顾性分析在该院接受鼻内镜手术治疗的315例CRSwNP患者的临床资料,根据患者术后1年内是否复发分为复发组和未复发组,比较两组的各项临床指标,筛选影响术后复发的相关危险因素。结果:315例患者中,57例复发(复发组),占18.10%,258例未复发(未复发组),占81.90%;Logistic多因素回归分析结果显示:多发性鼻息肉、鼻中隔偏曲、合并变应性鼻炎、合并支气管哮喘、EOS型鼻息肉、术后感染及不良心理状态是影响CRSwNP鼻内镜术后复发的独立危险因素(均P<0.05)。结论:CRSwNP鼻内镜术后复发率较高,其中病变程度、合并鼻中隔偏曲、有变应性鼻炎/哮喘病史、EOS型鼻息肉、术后感染及不良心理状态与术后复发明显相关,临床应重视上述因素并及时对伴有上述因素的患者实施对症干预,以减少术后复发。Objective:To investigate the recurrence of chronic rhinosinusitis with nasal polyps(CRSwNP)after endoscopic sinus surgery,and to analyze the related risk factors of recurrence.Methods:The clinical data of 315 patients with CRSwNP who underwent endoscopic sinus surgery were retrospectively analyzed.According to whether the patients relapsed within one year after operation,they were divided into recurrence group and non-recurrence group.The clinical indicators of the two groups were compared to screen the relevant risk factors affecting postoperative recurrence.Results:Among 315 patients,57 cases relapsed(recurrence group),accounting for 18.10%,and 258 cases did not relapse(non-recurrence group),accounting for 81.90%.Logistic regression analysis showed that multiple nasal polyps,deviated nasal septum,allergic rhinitis,bronchial asthma,EOS nasal polyps,postoperative infection and adverse psychological status were independent risk factors for postoperative recurrence of CRSwNP(all P<0.05).Conclusion:CRSwNP has a high recurrence rate after endoscopic sinus surgery.Among them,the degree of lesion,nasal septum deviation,history of allergic rhinitis/asthma,EOS nasal polyps,postoperative infection and adverse psychological status are significantly related to postoperative recurrence.Clinical attention should be paid to the above factors and symptomatic intervention should be implemented in patients with the above factors in time to reduce postoperative recurrence.

关 键 词：慢性鼻-鼻窦炎 鼻息肉 鼻内镜手术 术后复发 危险因素 调查研究 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]