鼻内镜手术治疗鼻窦炎伴鼻息肉患者复发的危险因素分析  

Risk factors for recurrence of sinusitis with nasal polyps after endoscopic sinus surgery

作　　者：潘杰 王志刚[1] 吴向东 PAN Jie;WANG Zhigang;WU Xiangdong(Department of Otolaryngology,Sujiatun District Central Hospital,Shenyang,Liaoning,110101,China)

机构地区：[1]沈阳市苏家屯区中心医院耳鼻喉科,辽宁沈阳110101

出　　处：《当代医学》2023年第24期164-166,共3页Contemporary Medicine

摘　　要：目的探讨鼻窦炎伴鼻息肉患者鼻内镜手术治疗后复发的危险因素。方法回顾性分析2020年6月至2021年6月本院收治的行鼻内镜手术治疗的80例鼻窦炎伴鼻息肉患者的临床资料,根据术后是否复发分为复发患者(n=6)与未复发患者(n=74),单因素分析和多因素分析复发患者的影响因素。结果复发患者鼻窦炎鼻息肉CT(Lund-Mackay)评分、视觉模拟评分法(VAS)评分、支气管哮喘史占比、长期应用鼻减充血剂占比、嗜酸性粒细胞型鼻息肉占比高于未复发患者,术后坚持综合治疗占比低于未复发患者,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,Lund-Mackay评分、嗜酸性粒细胞型鼻息肉、长期应用鼻减充血剂是影响患者术后复发的危险因素(OR>1,P<0.05),术后坚持综合治疗是独立保护因素(OR<1,P<0.05)。结论Lund-Mackay评分、嗜酸性粒细胞型鼻息肉、长期应用鼻减充血剂因素与鼻窦炎伴鼻息肉术后复发密切相关,在临床工作中应详细评估患者病情,制订科学合理的手术方案,督促患者完成术后治疗,进而有效改善预后。Objective To explore the risk factors for recurrence of sinusitis with nasal polyps after endoscopic sinus surgery.Methods The clinical data of 80 patients with sinusitis with nasal polyps treated by nasal endoscopic surgery in our hospital from June 2020 to June 2021 were retrospectively analyzed,they were divided into the recurrence patients(n=6)and the non-recurrence patients(n=74)according to whether the patients had recurrence after surgery.Univariate analysis and multivariate analysis were used to compare the influence of patients with recurrence.Results The CT(Lund-Mackay)score,visual analogue scale(VAS)score,proportion of history of bronchial asthma,long-term use of nasal decongestants and eosinophilic nasal polyps in the recurrent patients were higher than those in the non-recurrent patients,and the comprehensive treatment after operation was lower than that in the non-recurrent patients,the differences were statistically significant(P<0.05).Logistic regression analysis showed that Lund-Mackay score,eosinophilic nasal polyps and long-term use of nasal decongestants were the risk factors for postoperative recurrence(OR>1,P<0.05),and adherence to comprehensive treatment after operation was the independent protective factor(OR<1,P<0.05).Conclusion Lund Mackay score,eosinophilic nasal polyps,long-term use of nasal decongestant factors are closely related to postoperative recurrence of sinusitis with nasal polyps.In clinical work,we should evaluate the patient's condition in detail,formulate scientific and reasonable surgical plan,urge patients to complete postoperative treatment,and then effectively improve the prognosis.

关 键 词：鼻窦炎伴鼻息肉 鼻内镜 复发 危险因素 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]