鼻腔结构异常矫正对鼻内镜手术效果的影响

Clinical analysis on the therapeutic effect of a combined surgical therapy with rhinoplasty and sinus operation under nasal endoscope

目的观察鼻内镜下鼻腔结构矫形对鼻窦联合手术疗效的影响，并探讨其安全性和可行性。方法鼻息肉、鼻窦炎310例（487例），按照鼻内镜术中是否同期行鼻腔结构矫形分为2组，矫形组139例（223侧），对照组171例（264例）；术后随访6个月～2年。分析比较2组患者术后疗效及并发症发生情况。结果矫形组患者术中平均出血量为142．5ml，对照组为123．7ml，差异无统计学意义（P〉0．05）；矫形组并发症发生率34．5％、对照组31．6％，P〉0．05。矫形组总有效率97．3％，明显高于对照组的73．1％（P〈0．01）。结论鼻内镜下同期完成鼻腔结构矫形和鼻窦联合手术，能够明显提高鼻窦手术疗效，但不会增加术中出血量及术后并发症，安全性好。

Objection To observe the therapeutic effect of a combined surgical therapy with nasal orthomorphia and sinus operation under nasal endoscope and to explore the safety and feasibility of such a surgical procedure based on a clinical trial. Methods Included in this study were 310 cases （487 sides） with rhino-sinusitis and/or nasal polyps, being divided into two groups according to if the cases received the procedure of nasal orthomorphia, i.e. 139 cases （223 sides） in orthopedic group （OG） and 171 cases （164 sides） in no- orthopedic group （NOG）. All these cases were followed up for 6 months to 2 years after the operation to sum up and analyze the therapeutic effect and the incidence of post-operative complications in a comparative way between the two groups. Results The total effective rate was 97.3% among the cases in OG, significantly higher than that of 73.1% for those in NOG （P〈0.05）. However, the averaged volume of bleeding during the operation was 142.5 ml in OG, while such a mean volume was 123.7 ml in NOG, with no statistical significance between these two groups （P〉0.05）. Furthermore, the incidence of post-operative complications was 34.5% in OG and 31.6% in NOG （P 〉0.05）. Conclusions The combined therapy with nasal orthomorphia and sinus operation performed simultaneously under nasal endoscope can improve the therapeutic effect on such sinus lesions as chronic rhino-sinusitis and/or nasal polyps, with better safety but without the risk of increased bleeding volume during the operation and elevated incidence of post-operative complications for the patients receiving the surgery.