鼻窦炎鼻息肉患者鼻内镜手术后嗅觉功能障碍转归因素分析

Olfactory rehabilitation and relative influencing factors in sinusitis and nasal polyp patients after endoscopic sinus surgery

目的探讨鼻内镜手术后慢性鼻窦炎、鼻息肉所致嗅觉障碍的治疗效果,及可能影响嗅觉恢复各因素的作用。方法采用五味试嗅液检测法对79例慢性鼻窦炎、鼻息肉患者在鼻内镜手术前及术后第4周、第12周、第24周进行嗅觉功能测试,将检测资料进行统计学分析。结果①患者总体嗅觉水平术后3次检测结果与术前均有统计学差异(P<0.01);术后3次检测结果间无统计学差异(P>0.05)。②病情分级对鼻内镜术后嗅觉恢复影响有统计学意义,其标准化偏回归系数为0.325。结论①手术后4周内患者嗅觉功能较术前即有明显改善,术后1～6个月嗅觉变化不明显。②在病情分级、病程、过敏史、吸烟等九项嗅觉功能相关因素中,只有病情分级对鼻内镜术后嗅觉恢复的影响有意义。

Objective To evaluate the effects of endoscopic sinus surgery （ESS） on olfactory dysfunction caused by chronic sinusitis and nasal polyps, and to analyze the possible relative factors influencing olfactory rehabilitation. Methods Five odors were applied to testing the olfactory function of 79 patients with chronic sinusitis and nasal polyps before operation, 4 weeks, 12 weeks and 24 weeks after ESS respectively. All the results were statistically analyzed. Results ① The total results of olfactory function after ESS were significantly better than those before operation （ P 〈 0. 01 ） , while the differences between different time-points after ESS were statistically insignificant （ P 〉 0. 05 ）. ② The clinical stages of the diseases had statistically significant influence to olfactory rehabilitation with standard regression coefficient of 0. 325. Conclusion Olfactory function of the patients with chronic sinusitis and nasal polyps gets significantly improved within 4 weeks after ESS and no obvious further improvement can be observed in the following 5 months. Of all the 9 factors such as clinical stage, duration, allergic history or smoking etc. , the clinical stage is the only factor significantly influencing the olfactory rehabilitation in sinusitis and nasal polyps.