鼻内镜鼻窦手术治疗老年人慢性鼻窦炎的临床疗效

Clinical efficacy of endoscopic sinus surgery in elderly patients with chronic sinusitis

目的探讨鼻内镜手术治疗慢性鼻窦炎的临床疗效并分析其与临床分型分期的关系。方法对该科2004年1月～2008年12月间接受鼻内镜手术治疗的60岁以上慢性鼻窦炎老年患者,病变为双侧者218例,单例者33例,共计469侧。根据慢性鼻窦炎鼻息肉分型分期标准:Ⅰ型54侧(1期15侧,2期33侧,3期6侧);Ⅱ型273侧(1期12侧,2期168侧,3期93侧);Ⅲ型142侧。常规术前用药,行鼻内镜手术,术后定期随访观察疗效。结果按照海口疗效评定标准,Ⅰ～Ⅲ型疗效呈递减趋势,其中以Ⅱ型3期,Ⅲ型的疗效较差。差异有显著性(P<0.05)。术后出血量属正常,对原发老年病患者未见诱发现象,未见严重手术并发症。结论鼻内镜鼻窦手术是治疗老年人慢性鼻窦炎的有效方法,其疗效与临床分型分期有密切关系。

【Objective】To study the clinical efficacy of endoscopic sinus surgery for elderly patients with chronic sinusitis and analyze the relationship between the stages.【Methods】469 sides accepted the month of endoscopic sinus surgery in elderly patients with chronic sinusitis and other disorders：218 cases of bilateral,single cases were 33 cases,a total of 469 side. According to classification of chronic sinusitis and nasal polyps staging：Ⅰ stage 54 sides ,Ⅱ stage 273 sides ,Ⅲ stage142 sides. Routine preoperative medication was given,endoscopic sinus surgery,postoperative follow-up observation of curative effect on a regular basis. 【Results】According to assessment standards ,Ⅰ～Ⅲ type effect on the decrease,of which 3rd of Ⅱstage,Ⅰstage have poorer treatment outcomes. The amount of postoperative bleeding is normal for elderly patients seen in primary-induced phenomenon,no serious complications. 【Conclusions】Endoscopic sinus surgery is the treatment of elderly patients with chronic sinusitis effective method,its efficacy is closely related with clinical classification of stages.