内窥镜下鼻窦手术的探讨  

Research of endoscopic sinus surgery

作　　者：房晓萍[1] 

机构地区：[1]安徽滁州市第二人民医院耳鼻咽喉科,239000

出　　处：《中国基层医药》2003年第10期1012-1013,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　探讨各型鼻窦炎内窥镜下鼻窦手术的要点及影响疗效的相关因素。方法　接受内窥镜鼻窦手术的 10 6例 (187侧 )鼻窦炎病人 ,年龄 14～ 6 0岁 ,平均 31岁 ,男 76例 ,女 30例 ,全身麻醉 9例 ,局部麻醉 97例 ,10 6例术后随访 6～ 14个月 ,随访在鼻内镜下进行 ,术后综合治疗包括 :清理术腔 ,冲洗鼻腔 ,抗生素、激素、酶制剂的应用。结果　 10 6例 (187侧 ) ,治愈 76例 (71 7% ) ,好转 2 6例 (2 4 5 % ) ,无效 4例(3 8% ) ,总有效率 96 2 %。结论　术前常规鼻窦冠位CT扫描 ,对判定病变性质、范围、指导手术有特殊意义 ,术中应避免鼻窦周围重要结构的损伤 (颅底、眶纸板、鼻泪管、视神经、大血管等 )。坚持术后综合处理是防止复发 ,获得远期疗效的主要因素。Objective To evaluate the key features,the results and relative factors of endoscopic sinus surgery(ESS).Methods A total of 106 cases(187 sides);aged 14 to 60 years old(average,31),76 males,30 females,were included in this study(underwent ESS),anesthesia 9 cases;local anesthesia 97 cases.The post-operative follow-up time of 106 cases was 6 to 14 months.The management during follow-up was adopted under nasal endoscope.The post-operative treatment included operative cavity-cleaning,nasal-irrigating and the application of antibiotics,steroid.Results Of the 106 cases(187 sides),76 cases(71.7%) are cured,26 cases(24.5%) are improved,4 cases(3.8%) are of no effect.The total effective rate of ESS is 96.2%.Conclusion Doing CT scanning to normal pre-operation crown position of nasal sinus has a special meaning to the judgment of the nature and scope of the pathogenicity and the instruction of the operation.In the operation it should avoid the damage to the main structure of nasal sinus(which include skull base, thin plates of eye-socket,nasal tears tubes,visual nerves,main blood vessels).Sticking to the post-comprehensive treatment is the important to prevent the recurrence of illness and to gain the good long-term outcomes.

关 键 词：内窥镜 鼻窦炎 鼻窦手术 手术方法 疗效 影响因素 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]