复发性鼻窦炎鼻息肉的修正性手术及综合治疗探讨

Revison endoscopic sinus surgery and combined therapy for recurrent sinusitis

目的:探讨对复发性鼻窦炎、鼻息肉采用修正性手术及综合治疗的临床疗效。方法:对72例复发性鼻窦炎、鼻息肉患者行修正性鼻内镜手术,其中3例行鼻内镜下鼻腔外侧壁切开上颌窦手术,16例行Draf(Ⅰ～Ⅱ)鼻内额窦引流术,并且对所有患者进行综合治疗(包括围手术期用药及术后鼻内镜定期复查清除残余息肉、肉芽、囊泡)。结果:72例(109侧)患者随访1年以上,其中治愈52例,好转14例,无效6例,治疗有效率为91.67%(66/72),且手术无严重的并发症发生。结论:充分的术前准备、熟练的手术操作、合理的围手术期用药以及加强术后随访时的鼻内镜定期复查是提高复发性鼻窦炎、鼻息肉手术疗效的关键因素。

Objective：To investigate the efficacy of revison endoscopic sinus surgery and combined therapy on recurrent sinusitis and polyps. Method：Revison endoscopic sinus surgery was performed in 72 patients, of which endoscopic nasal lateral wall dissection was used in 3 cases, the endoscopic frontal sinus surgery （Draf Ⅰ-Ⅱ] ） was used in 16 cases, and all patients received combined therapy including peri-operation conservative management and nasal endosopy examination during the follow-up period. Result： All patients were followed up for more than one year. Of 72 patients, 52 patients were successfully cured, 10 patients showed improvement, but there was no change in other 13 patients. The total efficacy rate was 91.67%（66/72）. No serious complication occurred. Conclusion：The treatment efficacy can be greatly improved by enough preoperative preparation, fine operation, combined prei-operation conservative therapy and postoperative follow-up.