鼻内镜手术在AS治疗中的应用及患者术后复发的相关因素  

Application of nasal endoscopic surgery in the therapy of AS and the related factors of postoperative relapse of patients

作　　者：孙子慧 何双八[1] 张庆翔[1] 鲁志琴 SUN Zi-hui;HE Shuang-ba;ZHANG Qing-xiang;LU Zhi-qin(Department of Otolaryngology,Nanjing Tongren Otolaryngology Hospital,Nanjing Tongren Hospital,Southeast University School of Medicine,Nanjing 211102,Jiangsu,China)

机构地区：[1]东南大学医学院附属南京同仁医院耳鼻咽喉头颈外科·南京同仁耳鼻喉医院,江苏南京211102

出　　处：《川北医学院学报》2023年第10期1396-1399,共4页Journal of North Sichuan Medical College

基　　金：南京同仁医院科研项目(2021E009)。

摘　　要：目的:探讨鼻内镜手术在急性鼻窦炎(AS)治疗中的应用效果及患者术后复发的相关因素。方法:选取106例AS患者为研究对象,均行鼻内镜手术治疗,根据术后6个月内是否复发将患者分为复发组(n=27)和未复发组(n=79)。比较两组患者临床资料及手术前、手术后3个月、6个月的病情[视觉模拟量表(VAS)评分]和临床症状(鼻内镜Lund-Kennedy评分),分析影响患者术后复发的因素。结果:患者手术时间(44.57±7.15)min,术中出血量(52.34±6.81)mL;住院时间(5.89±1.73)d。术后6个月并发症的总发生率为12.26%,复发率为25.47%。两组患者VAS评分、Lund-Kennedy均随时间推移而降低(P<0.05),且术后3个月、6个月复发组患者高于未复发组(P<0.05)。两组患者年龄、性别、饮酒、糖尿病比较,差异无统计学意义(P>0.05),吸烟、鼻息肉、变应性鼻炎、支气管哮喘、VAS评分、Lund-Kennedy评分、窦口鼻窦复合体(OMC)评分比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,不吸烟、无鼻息肉、无变应性鼻炎、无支气管哮喘是AS患者经鼻内镜手术治疗术后复发的保护因素;VAS评分高、Lund-Kennedy评分高、OMC评分高是患者术后复发的危险因素。结论:鼻内镜手术治疗AS患者具有手术时间短、创伤小、术后恢复快、安全性好等特点。吸烟、鼻息肉、变应性鼻炎、支气管哮喘以及VAS评分、Lund-Kennedy评分、OMC评分是AS患者术后复发的影响因素。Objective:To explore the application effect of nasal endoscopic surgery in the therapy of acute sinusitis(AS)and the related factors of postoperative relapse of patients.Methods:106 AS patients were selected,and they were underwent the nasal endoscopic surgery for therapy.They were divided into a recurrent group(n=27)and a non recurrent group(n=79)according to whether they recurred within 6 months after surgery.The clinical data,condition[visual analog scale(VAS)],and clinical symptoms[nasal endoscopic Lund-Kennedy scores]at before surgery,3 and 6 months after surgery were compared between the two groups,and the factors affecting postoperative recurrence were analyzed.Results:The surgical time was(44.57±7.15)min,the intraoperative blood loss was(52.34±6.81)mL,the length of hospitalization was(5.89±1.73)d.The total complex disease rate was 12.26% and the relapse rate was 25.47% at 6 months after surgery.The VAS and Lund-Kennedy scores of both group were decreased with time(P<0.05),and the VAS and Lund-Kennedy scores of the relapse group at 3 and 6 months after surgery were higher compared with the non-relapse group(P<0.05).The age,gender,alcohol consumption and diabetes of both groups were not significant differences(P>0.05),but the smoking,nasal polyps,allergic rhinitis,bronchial asthma,VAS,Lund-Kennedy and ostiomeatal complex(OMC)scores of both groups were significant differences(P<0.05).Multivariate Logistic regression analysis showed that no smoking,no nasal polyps,no allergic rhinitis and no bronchial asthma were protective factors for postoperative relapse of AS patients after nasal endoscopic surgery,and high VAS,Lund-Kennedy and OMC scores were risk factors for postoperative relapse.Conclusion:Nasal endoscopic surgery in the therapy of AS patients has the characteristics of short surgical time,less trauma,quick postoperative recovery and good safety.Smoking,nasal polyps,allergic rhinitis,bronchial asthma,VAS,Lund-Kennedy and OMC scores are all influencing factors for postoperative relapse in AS patients

关 键 词：鼻内镜手术 急性鼻窦炎 复发 影响因素 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]