慢性鼻窦炎患者行鼻内窥镜术后发生粘连的影响因素分析  

Analysis of influencing factors of adhesion in patients with chronic sinusitis after endoscopic sinus surgery

作　　者：周寅飞 Zhou Yinfei(Department of Otorhinolaryngology,Livang People's Hospital,Liyang,Jiangsu,213300,China)

机构地区：[1]溧阳市人民医院,江苏溧阳213300

出　　处：《中国医学文摘（耳鼻咽喉科学）》2024年第5期94-97,共4页Chinese Medical Digest(Otorhinolaryngology)

摘　　要：目的探讨慢性鼻窦炎患者行鼻内窥镜术后发生粘连的影响因素。方法选取本院2018年1月~2022年12月就诊收治的98例经鼻内窥镜手术治疗的慢性鼻窦炎患者。并记录患者相关临床资料,采用多因素Logistic回归分析影响术后粘连发生的相关因素。结果本研究中的98例经鼻内窥镜治疗的慢性鼻窦炎患者中,共有19例发生了术后粘连,其发生率为19.39%。两组患者在性别、年龄、BMI、填塞时间方面比较无明显差异(P>0.05),在病情程度、填塞材料、既往鼻部手术史、中鼻甲的处理情况、鼻腔术后定期清理情况及术后感染等比较有统计学意义(P<0.05);病情程度重、填塞材料为凡士林纱布、既往有鼻部手术史、中鼻甲未处理、鼻腔术后未定期清理、合并感染均为鼻内窥镜术后发生粘连的独立危险因素(OR=3.927、1.879、2.375、2.134、3.370、4.797,P<0.05)。结论慢性鼻窦炎患者行鼻内窥镜术后易发生粘连,和病情程度重、填塞材料、既往有鼻部手术史、中鼻甲未处理、鼻腔术后未定期清理、合并感染等密切相关,临床应注意,给予提前预防及干预。Objective To investigate the influencing factors of adhesion in patients with chronic sinusitis after endoscopic sinus surgery.Methods A total of 98 patients with chronic sinusitis treated by endoscopic operation were selected from January 2018 to December 2022.The relevant clinical data of patients were recorded,and the related factors affecting postoperative adhesion were analyzed by multivariate Logistic regression.Results Among the 98 patients with chronic sinusitis treated with intranasal endoscope in this study,a total of 19 patients had postoperative adhesion,with an incidence of 19.39%.There were no significant differences in gender,age,BMI and tamponade time between the two groups(P>0.05),but there were statistically significant differences in disease severity,tamponade materials,previous nasal operation history,treatment of middle turbinate,regular postoperative nasal cleaning and postoperative infection between the two groups(P<0.05).The severity of the disease,Vaseline gauze as the packing material,previous nasal operation history,middle turbinate not treated,nasal cavity not cleaned regularly after operation,and complicated infection were all independent risk factors for postoperative adhesion(OR=3.927,1.879,2.375,2.134,3.370,4.797,P<0.05).Conclusions Postoperative adhesion is easy to occur in patients with chronic sinusitis after endoscopic sinus surgery,which is closely related to the severity of the disease,packing materials,previous nasal operation history,middle turbinate not treated,nasal cavity not cleaned regularly after operation,and complicated infection.Clinical attention should be paid,prevention and intervention should begiven.

关 键 词：慢性鼻窦炎 鼻内窥镜:术后粘连 影响因素 

分 类 号：R76[医药卫生—耳鼻咽喉科]