慢性鼻窦炎鼻息肉鼻内镜术后随访的必要性

The implications of post-operative following up and operative cavity clearing in the recovering process of patients with the nasosinusitis and/or nasal polyps undergone endoscopic sinus surgery

目的探讨慢性鼻窦炎鼻息肉鼻内镜术后定期随访的意义。方法2001年4月～2005年4月间在我科接受鼻内镜手术的慢性鼻窦炎鼻息肉患者308例(530侧),除了42例(68侧)患者的随访观察过程不规则外,其余266例(462侧)均进行了规律的随访与术腔清理。比较分析两组病例不同随访经历对疾病恢复过程的影响。结果经历规律、定期、及时复查处理的患者中,仅15例(27侧)出现息肉复发,其余均治愈;未经定期复查的患者中,37例(57侧)发生鼻腔粘连,26例(32侧)息肉复发,31例(54侧)窦口引流不畅。结论慢性鼻窦炎鼻息肉患者接受鼻内镜手术后,定期、规律、及时的术后随访和术腔清理与规范、彻底的手术操作具有同等重要的意义。

Objective To investigate the implications of post-operative following up and operative cavity clearing in the recovering process of patients with nasosinusitis and/or nasal polyps undergone endoscopic sinus surgery. Methods Included in this study were 308 cases （530 sides） with nasosinusitis and/or nasa 1 lzolyps undergone endoscopic sinus surgery in our Hospital from Apr 2001 to Apr 2005. Other than 42 cases （68 sides） received irregular post-operative following up and operative cavity cleating, all the other cases were given regular post-operativd treatment during the following up period after endoscopic sinus surgery. Then, a comparative analysis was made between the two groups of patients to explore the implications of post-operative following up in the recovering process of these cases. Results Among the patients received regular post-operative treatment during the following up period, all were cured except 15 （27 sides） with lesions retainS. In contrast, the rates of lesion relapse and complications occuming were very high among the 42 patients （ 68 sides） undergone irregular post-operative following up and operative cavity clearing during the following up period, with 37 cases （57 sides） nasal adhesion, 26 ones （32 sides） with reoccurred nasal polyps, and 31 ones （54 sides） with incomplete construction in the drainage of sinuses ostium. Conclusion It holds the similar importance as that of standar dized and well-done primary endoscopic sinue surgery on chronic nasosinusitis and/or nasal polyps that timely, following up and operative cavity clearing at regular pattern and fixed intervals should be given to these patients after the operation.