难治性鼻窦炎鼻窦开放联合中上鼻甲部分切除疗效分析

Analysis of the Curative Effect of Sinus Opening Combined with Partial Resection of Middle and Upper Turbinates for Refractory Rhinosinusitis

目的分析难治性鼻窦炎鼻窦开放联合中上鼻甲部分切除疗效。方法方便选取2018年1月—2021年1月该院收治的65例难治性鼻窦炎患者进行回顾性研究,按不同手术方法分为两组,对照组30例采用常规内镜下鼻窦开放术;观察组35例,采用内镜下鼻窦开放术联合中上鼻甲部分切除术;比较两组患者手术治疗后12个月的疗效、并发症、复发率及鼻部功能。结果观察组手术效果总有效率91.43%高于对照组的70.00%,并发症发生率2.86%低于对照组的23.33%,术后12个月复发率11.43%低于对照组的33.33%,差异有统计学意义(χ^(2)=4.928、4.525、4.587,P=0.026、0.033、0.032)。观察组术后12个月鼻腔鼻窦结局测试20(SNOT-20)评分、鼻道阻力低于对照组,嗅觉功能优于对照组,差异有统计学意义(P<0.05)。结论难治性鼻窦炎患者经内镜下鼻窦开放术联合中上鼻甲部分切除术取得显著效果,可减少鼻腔黏膜组织粘连的发生,降低鼻气道阻力,临床意义高。

Objective To analyze the efficacy of sinus opening combined with partial resection of middle and upper turbinates for refractory rhinosinusitis.Methods A retrospective study was performed on 65 patients with refractory sinusitis who were conveniently selected and admitted to the hospital from January 2018 to January 2021,and divided them into two groups according to different surgical methods.30 patients in control group,received conventional endoscopic sinus opening.35 cases in the observation group were treated with endoscopic sinus opening combined with partial resection of the middle and upper turbinates.The curative effect,complications,recurrence rate and nasal function at 12 months after surgery were compared between the two groups.Results The total effective rate of operation in the observation group was 91.43%higher than that that in the control group 70.00%,and the complication rate was 2.86%lower than that in the control group 23.33%,and the recurrence rate at 12 months after operation was 11.43%lower than 33.33%in the control group,and the difference was statistically significant(χ^(2)=4.928,4.525,4.587,P=0.026,0.033,0.032).The nasal cavity and sinus outcome test 20(SNOT-20)score and nasal passage resistance of the observation group were lower than those of the control group at 12 months after operation,and the olfactory function was better than that of the control group,the difference was statistically significant(P<0.05).Conclusion Endoscopic sinus opening combined with partial middle and upper turbinate resection in patients with refractory sinusitis can achieve significant results,which can reduce the occurrence of nasal mucosal tissue adhesion and reduce nasal airway resistance,which is of high clinical significance.