鼻内镜与上颌窦鼻内开窗术对慢性鼻-鼻窦0--0炎黏膜纤毛功能的影响  

Influence of functional endoscopic sinus surgery and maxillary sinus intranasal fenestration on nasal mucociliary function of chronic rhinosinusitis

作　　者：张伟东 杨琳 朱玉轩 Zhang Wei-dong;Yang Lin;Zhu Yu-xuan(Department of Otolaryngology,Dexing Hospital of Traditional Chinese Medicine,Dexing 334200,Jiangxi,China)

机构地区：[1]德兴市中医院耳鼻喉科,江西德兴334200

出　　处：《四川生理科学杂志》2024年第12期2732-2734,2802,共4页

摘　　要：目的:对比功能性鼻内镜手术(Functional Endoscopic Sinus Surgery,FESS)与上颌窦鼻内开窗术对慢性鼻-鼻窦炎(Chronic Rhinosinusitis,CRS)患者鼻黏膜纤毛功能的影响。方法:收集2023年1月至2024年1月期间我院收治的CRS患者70例,根据所采用的手术治疗方法,将患者分为开窗组(n=33,上颌窦鼻内开窗术治疗)和FESS组(n=37,FESS治疗)。手术前后,对比两组患者的鼻腔鼻窦症状评分(Visual Analogue Scale,VAS)、鼻部黏膜形态评分(Modified Lund-Kennedy Nasal Endoscopy Scoring System,MLK)、鼻黏膜纤毛功能指标、生活质量评分(Sino-Nasal Outcome Test-20,SNOT-20)。结果:术后6 m,2组患者的VAS、MLK、SNOT-20评分均下降,且FESS组低于开窗组(P<0.05);2组患者的鼻黏膜纤毛传输速率、鼻黏膜纤毛清除率均增大,且FESS组大于开窗组(P<0.05)。结论:相较于上颌窦鼻内开窗术,FESS更有利于CRS患者术后鼻黏膜纤毛功能的恢复,还可有效改善CRS患者的鼻腔通气、引流、鼻部黏膜状况和生活质量。Objective:To compare the influence of functional endoscopic sinus surgery(FESS)and maxillary sinus intranasal fenestration on nasal mucociliary function in patients with chronic rhinosinusitis(CRS).Methods:Seventy patients with CRS in the hospital from January 2023 to January 2024 were collected.According to the surgical treatment methods,the patients were divided into fenestration group(n=33,maxillary sinus intranasal fenestration)and FESS group(n=37,FESS treatment).Visual Analogue Scale(VAS),Modified Lund-Kennedy Nasal Endoscopy Scoring System(MLK),nasal mucociliary function indexes and Sino-Nasal Outcome Test-20(SNOT-20)were compared between groups before and after surgery.Results:At 6 months after surgery,the scores of VAS,MLK and SNOT-20 in the two groups were decreased,and the above scores in FESS group were lower than those in fenestration group(P<0.05).The nasal mucociliary transport rate and nasal mucociliary clearance rate were enhanced in both groups,and the indexes were higher in FESS group than those in fenestration group(P<0.05).Conclusion:Compared with maxillary sinus intranasal fenestration,FESS is more conducive to the recovery of postoperative nasal mucociliary function in patients with CRS,and can more effectively improve nasal ventilation,drainage,nasal mucosal status and quality of life in patients with CRS.

关 键 词：慢性鼻-鼻窦炎 鼻内镜手术 上颌窦鼻内开窗术 鼻黏膜纤毛功能 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]