慢性鼻窦炎鼻息肉鼻内镜术后术腔清理临床分析

Clinical analysis of 70 cases of postoperative management by using nasal endoscopic surgery for chronic sinusitis and nasal polyp

目的探讨慢性鼻窦炎鼻息肉在行鼻内镜手术后术腔清理对鼻窦结构和上皮功能恢复的影响。方法70例慢性鼻窦炎鼻息肉患者均采用Messerklinger术式完成鼻窦内窥镜手术。术后第4天进行第1次鼻腔清理,术后第1个月每周清理1次,第2-3个月每2周清理1次,第4-6个月每月清理1次,随访至少6个月至术腔基本上皮化。结果70例慢性鼻窦炎鼻息肉患者中,有11例、24例和23例分别于术后1个月、2个月和3个月术腔基本上皮化;8例出现术腔粘连;5例出现窦口闭锁;在鼻腔清理时进行处理,这些并发症均消失,4例术后复发,总有效率为94.3%。结论术腔黏膜的再上皮化对于慢性鼻窦炎鼻息肉鼻内镜术后鼻窦功能恢复至关重要,这个过程一般需要1-3个月甚至更长的时间,手术后规范化的鼻腔清理能早期发现并处理黏膜病变、术腔狭窄及窦口阻塞,因而术腔清理对提高慢性鼻窦炎鼻内镜手术疗效有重要的价值。

Objective To explore the effects of postoperative management for patients of chronic sinusitis and nasal polyp with endoscopic surgery on recovery of sinus cavity＇ structure and sinus epithehal functionn. Methods The subjects consists of 70 cases received Messerklinger surgical approach. All cases received the first clearing treatment in the fourth day after endoscopic surgery. Then this treatment was performed once every week in the first month, every two weeks from the 2 - 3 month, every four weeks from the 4 - 6 month after operation. All patients were followed up six months or more time until the sinus cavity were almost epithehzed. Results The results showed that 11 cases, 25cases, 15 cases were epithelized one month, two months and three months, respectively. 8 cases presented sinus adhesion, 5 cases occurred ostiums atresia . -All the complications disappeared after cleating treatment. 4 cases experienced recurrence. The total effective rate was 94.3%. Conclusion Recpithelization is very important for recovery of surgical cavity mucosa. Postoperative management might be valuable for increasing effect of nasl endoscopic surgery.