鼻内镜手术治疗慢性鼻窦炎鼻息肉573例疗效分析

The effect of the endoscopic sinus surgery in treating chronic sinusitis and nasal polyps

目的探讨鼻内镜手术治疗慢性鼻窦炎鼻息肉的疗效。方法回顾性分析2004年8月至2008年4月本院收治的573例慢性鼻窦炎鼻息肉患者的临床资料,所有病例均行鼻内镜手术治疗,对伴有鼻腔解剖变异者同期行手术矫正,术后随访6个月以上,按海口标准进行疗效评定。结果本组573例治愈率75.9%,好转率20.8%,无效率3.3%,总有效率96.7%;2例眶周有轻微瘀血肿胀,3~4 d后即自行消退;10例于术后5~12 d鼻腔有少量出血,为术腔脱痂壳引起,在鼻内镜下用微波烧灼后好转;1例在术后5 d鼻腔出现大出血引起失血性休克,立即予微波止血、输血、扩容等治疗后好转;7例鼻腔有不同程度的粘连,于局部麻醉下松解粘连、予明胶海绵分隔创面后好转。结论鼻内镜手术是治疗慢性鼻窦炎鼻息肉的有效方法 ,术中同期处理鼻腔的解剖变异,可提高远期疗效。

Objective To explore the curative effects of the endoscopic sinus surgery in treating chronic sinusitis and nasal pol- yps. Methods A retrospective study was carried out in a group of 573 patients with chronic sinusitis and nasal polyps treated in our hospital from Aug, 2002 to Apr, 2006, with a following up period lasted for more than 6 months. All patients were underwent the endoscopic sinus surgery, and anatomic variations in the nose accompanying them were disposed simultaneity. The curative effects were assessed according to the HaiKou Standards. Results In this group of 573 cases,the curative rate was 75.9~, the im-- proving rate was 20.8%, the ineffective rate was 3.3~, the total effective rate was 96.7%. Periorbital ecchymoma was appeared in 2 cases and was faded spontaneously after 3-4 days. Epistaxis happened at postoperative 5 12 day was stanched by microwave cauterization in 10 cases. Hemorrhagic shock was occurred at postoperative 5 day in 1 case for one of artery branch haemorrhage and the bleeding was eauterizated by microwave immediately, the anti-shock measures such as blood transfusion and liquid expan- sion were applied simultaneity. Conglutinations in nasal cavity were appeared in 7 cases and were cured by separating it. Conclusion The endoscopic sinus surgery offers an effective operation for the patients with chronic sinusitis and nasal polyps. Disposing the anatomic variations in the nose simultaneity maybe improve the long curative effects obviously.