经鼻内镜手术治疗慢性鼻窦炎162例临床分析

Endoscopic surgery for chronic rhinosinusitis in 162 cases

目的:探讨经鼻内镜手术治疗慢性鼻窦炎的疗效及相关影响因素。方法:对我院2004年7月～2010年6月间实施经鼻内镜手术治疗并完成随访6个月以上的162例慢性鼻窦炎患者的临床资料进行回顾性总结。结果:术后随访6～37个月,总治愈率为71.0%,总有效率为95%,Ⅰ型、Ⅱ型、Ⅲ型总有效率分别为100.0%、95.6%、85.0%;Ⅰ型治愈率(93.1%)明显高于Ⅱ、Ⅲ型(69.9%、45.0%)(P<0.05),Ⅱ型治愈率明显高于Ⅲ型(P<0.05),手术并发症18例(11.1%),分别为纸样板损伤5例(3.1%),鼻腔粘连11例(6.8%),鼻中隔穿孔2例(1.2%)。结论:经鼻内镜手术是治疗慢性鼻窦炎的有效方法,疗效与分型有关,规范的手术操作和术后定期随访、处理是提高疗效的关键。

Objective：To study the curative effect of endoscopic sinus surgery in treatment of chronic rhinosinusitis.Methods： The clinical data of 162cases subjected to ESS from July 2004 to June 2010 were retrospectively analyzed.All the cases were followed up more than 6 months after operation.Results： Patients with clinical types from Ⅰ to Ⅲ were 29 cases（17.9%）,113 cases（69.8%）,20cases（12.3%） respectively.With 6~37 month follow-up,the clinical cure rate from Ⅰ to Ⅲwere 93.1%、69.9%、45% respectively.The total cure rate was 71%,complications were noted in 18 cases（11.1%）.The types of complication included papyraceous lamina injury in 5 cases（3.1%）,hemorrhage in 11cases（6.8%）,perforation of the nasal septum in 2 cases（1.2%）.Conclusions： endoscopic sinus surgery is an effective method in the treatment of chronic rhinosinusitis.The operation outcome is directly related to the type of the disease.A standardize operation and normative treatment after the operation are the keys to improve the cure rate.