经鼻内镜开放蝶筛窦切除多发性鼻息肉远期疗效观察

Long-term effect of nasal polypectomy via endoscopic sphenoethmoidectomy

目的应用鼻内镜开放蝶筛窦切除多发性鼻息肉的远期疗效观察。方法收集1998年1月～2001年12月47例多发性鼻息肉患者资料,其中单纯鼻息肉病患者30例,伴有支气管哮喘者17例。依照VAS0～10评分系统,比较术前术后(至少5年)的症状评分、鼻窦CT的Lund-Mackay评分、伴有哮喘患者的术前与术后5年肺功能及激素用量的变化。结果术前患者最严重的主诉是嗅觉丧失和鼻阻塞,术后鼻阻塞和嗅觉明显改善的患者数分别是28例和31例;鼻窦CT扫描,术前、术后平均Lund-Mackay记分分别为19和6.5;17例伴有哮喘的患者中,13例激素用量明显减少。截止2001年12月,15例患者前筛出现复发性息肉。结论多发性鼻息肉患者行鼻内镜下开放蝶筛窦切除息肉,长期疗效较稳定可靠。

Objective To investigate the long-term effect of nasal polypectomy via endoscopic sphenoethmoidectomy. Methods Clinical data of 47 nasal polyposis patients receiving polypectomy via endoscopic sphenoethmoidectomy from Jan. 1998 to Dec. 2001 was analyzed retrospectively. Of them, 30 suffered from nasal polyposis and 17 suffered from nasal polyposis accompanied with bronchial asthma. All the patients were followed up more than 5 years; their postoperative scores of nasal symptoms, CT Lund-Mackay scores, pulmonary function, and the quantity of steroid used for controlling asthma were compared with the preoperative ones. Results The most predominant preoperative complaints were anosmia and nasal obstruction. The number of patients with an improvement in nasal obstruction and anosmia was 28 and 31 respectively after operation. The average preoperative CT Lund-Mackay score was 19 and that of postoperative was 6. 5. As for the steroid, the dosage decreased significantly in 13 of the 17 cases. Up to Dec. 2001, 15 cases of nasal polyp recurred in the anterior ethmoid sinus. Conclusion The long-term effect of nasal polypectomy via endoscopic sphenoethmoidectomy on nasal polyposis was reliable and stable.