不同入路鼻内镜治疗慢性鼻窦炎的临床疗效及对鼻腔通气功能、炎症因子、复发率的影响  

Clinical efficacy of different nasal endoscopic approaches in the treatment of chronic sinusitis and its effects on nasal ventilation function,inflammatory factors and recurrence rate

作　　者：李霞[1] 侯艳 贺玉良[1] 魏斌宏[1] 李利民[1] LI Xia;HOU Yan;HE Yu-liang(Department of Otolaryngology,Bayannur Hospital,Bayannur,Inner Mongolia 015000,China;Department of Otolaryngology,Affiliated Hospital of Inner Mongolia Minzu University,Tongliao,Inner Mongolia 017099,China)

机构地区：[1]巴彦淖尔市医院耳鼻咽喉科,内蒙古巴彦淖尔015000 [2]内蒙古民族大学附属医院耳鼻喉科,内蒙古通辽017099

出　　处：《临床和实验医学杂志》2023年第23期2558-2562,共5页Journal of Clinical and Experimental Medicine

基　　金：2022年度内蒙古自治区卫生健康科技计划项目(编号:202201630)。

摘　　要：目的研究不同入路鼻内镜治疗慢性鼻窦炎(CRS)的临床疗效及对鼻腔通气功能、炎症因子、复发率的影响。方法前瞻性选择2017年1月至2018年12月于巴彦淖尔市医院接受治疗的CRS患者96例,依据随机数字表法将其分为钩突入路组(n=48)、鼻丘入路组(n=48)。钩突入路组行钩突入路鼻内镜术,鼻丘入路组行鼻丘入路鼻内镜术。比较两组的临床疗效。比较两组的术前、术后7 d血清白细胞介素-6(IL-6)、C反应蛋白(CRP)等炎症因子水平,术前、术后3个月鼻腔容积(NCV)、鼻腔最小横截面积(NMCA)及鼻气道阻力(NAR)等鼻腔通气功能指标,并比较两组术后并发症及复发情况。结果两组总有效率比较,差异无统计学意义(P>0.05)。术后7 d,两组NCV、NMCA均较术前增加,NAR均较术前减小,差异均有统计学意义(P<0.05);但两组术后NCV、NMCA、NAR比较,差异均无统计学意义(P>0.05)。术后7 d,两组的血清IL-6、CRP水平均较术前降低,且钩突入路组的血清IL-6、CRP水平分别为(102.10±13.54)pg/mL、(3.31±0.36)mg/L,均低于鼻丘入路组[(148.45±16.76)pg/mL、(5.87±0.73)mg/L],差异均有统计学意义(P<0.05)。钩突入路组术后并发症发生率、复发率分别为6.25%、0,均低于鼻丘入路组(20.84%、12.50%),差异均有统计学意义(P<0.05)。结论钩突入路鼻内镜术、鼻丘入路鼻内镜术治疗CRS均可清除病变,改善鼻腔通气功能,提高疗效,但钩突入路鼻内镜术可经保留或修复钩突有效缓解术后炎症反应,降低术后并发症发病率、复发率,较鼻丘入路鼻内镜术具有一定优势。Objective To study the clinical efficacy of different nasal endoscopic approaches in the treatment of chronic sinusitis(CRS)and its effects on nasal ventilation function,inflammatory factors and recurrence rate.Methods A total of 96 patients with CRS treated in Bayannur Hospital from January 2017 to December 2018 were prospective selected and divided into hook-popping nasal endoscopy group(n=48)and nasal mound approach group(n=48)according to random number table method.The hook-out approach group received hook-out approach nasal endoscopy,and the nasal collus approach group received nasal collus approach nasal endoscopy.The clinical efficacy of the two groups was compared.The levels of inflammatory factors such as serum interleukin-6(IL-6)and C reactive protein(CRP)before and 7 d after operation,nasal ventilation function such as nasal cavity volume(NCV),nasal cavity minimum cross-sectional area(NMCA),and nasal airway resistance(NAR)before and 3 months after operation were observed and compared.And the postoperative complications and recurrence between the two groups were compared.Results Seven days after operation,NCV and NMCA in two groups were higher than those before surgery,while NAR were lower than those before surgery,the differences were statistically significant(P<0.05);however,there was no statistically significant difference in postoperative NCV,NMCA,and NAR between the two groups(P>0.05).After 7 d after operation,the levels of serum IL-6 and CRP in two groups were lower than those before surgery,and the levels of serum IL-6 and CRP in the hook-popping nasal endoscopy group were(102.10±13.54)pg/mL and(3.31±0.36)mg/L,respectively,which were lower than those in the nasal colliculus approach group[(148.45±16.76)pg/mL and(5.87±0.73)mg/L],the differences were statistically significant(P<0.05).There was no statistically significant difference in the total effective rate between the two groups(P>0.05).The incidence and recurrence rates of postoperative complications in the uncinate approach group were 6.2

关 键 词：鼻窦炎 钩突入路 鼻丘入路 鼻腔功能 炎症因子 凝血功能 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]