中鼻甲成形术在鼻内窥镜手术中的应用

The Application of Middle Turbineplasty Sinus Surgery

目的探讨中鼻甲成形术在慢性鼻窦炎鼻息肉内镜治疗中的作用。方法222例慢性鼻窦炎鼻息肉病人中72例行中鼻甲成形,102例行部分切除未成形或中鼻甲全切,48例未处理中鼻甲。术后观察中鼻甲形态、粘连情况、术腔上皮化情况等。结果中鼻甲成形组中鼻甲与鼻腔外侧壁粘连发生率为20.8%(15/72),未成形组52.5%(21/40),保留中鼻甲组86.3%(19/22)(p<0.01)。术后鼻腔结痂干燥感发生率:成形组13.7%(10/72),未成形组30.0%(12/40),保留中鼻甲组9.1%(2/22)(p<0.01)。术后术腔上皮化时间:成形组6.5周,未成形组10周,保留中鼻甲组6周。结论中鼻甲成形术既保留了中鼻甲的形态和生理功能,又开放了窦口鼻道复合体,可以缩短术后鼻腔清理时间,促使术腔尽快上皮化,防止术后粘连,对提高鼻内镜的疗效有积极的作用。

Objective To explore the impact on endoscopes sinus surgery by the middle turbineplasty for treating the patients who had chronic sinusitis and nasal poly. Methods We compared the features of middle turbinate , the adhesion and epitheliation of cavities of 222 patients who were treated in hospital . 72 of these patients were treated by middle turbineplasty;102 of them were treated by partial middle turbinectomy or total middle turbinectomy and 48 patients without dealing with middle turbinate. Results we observed the adhesion of cavities. It appeared in about 20. 8% patients who had partial middle turbinectomy and in 86.3% patients who kept their middie turbinate. 52.5% of patients who had not been treated to middle turbinate had the adhesion（p 〈 0. 01 ）. After surgery, we noted that the ratio of scabbing and desiccation of cavity. In patients with middle turbineplasty, the ratio is about 13.7%. In those without treating middle turbinate, the ratio is 30. 0%. And in those who kept the middle turbinate, it＇s about 9. 1% . （p 〈0. 01 ）. The time of epitheLization of patients with middle turbineplasty is 6.5 weeks and 10 weeks of patients without being treated. It＇s about 6 weeks of those kept middle turbinate. Conclusion The middle turbineplasty preserved the features and physiological functions of middle turbinate,and made the OMC open, shortened the time of clearing cavities, urged the epitheliation and prevented the adhesion. So, the middle turbineplasty can improve the effect of endoscopic sinus surgery positively.