内窥镜鼻窦手术1268例临床分析

The outcome of 1268 cases of endoscopic sinus surgery

目的 探讨鼻内窥镜手术治疗慢性鼻窦炎和鼻息肉的疗效及影响手术疗效的相关因素。方法 对 1 989～ 1 997年完成随访的 1 2 6 8例内窥镜鼻窦手术进行临床分析。 1 2 6 8例中 1型 36 6例 (2 8 9% ) ,2型为 6 46例 (5 0 9% ) ,3型为 2 5 6例 (2 0 2 % )。其中 1 2 6 2例在局部麻醉辅以静脉强化麻醉下完成。同期行鼻中隔矫正术 1 82例。术后随访 9～ 42个月 ,平均 1 5个月。结果 1型治愈率为93 7% ,2型治愈率为 81 6 % ,3型治愈率为 6 8 4 %。三型之间治愈率差异有显著性 (P <0 0 1 )。手术并发症的发生率为 2 3%。结论 鼻内窥镜手术是治疗慢性鼻窦炎和鼻息肉的有效方法 ,手术疗效与其临床分型密切相关。

Objective To evaluate the curative effect of endoscopic sinus surgery (ESS) Methods One thousand two hundred and sixty eight cases with chronic sinusitis and nasal polyps undergone ESS from 1989 to 1997 were appraised with the standard criteria (Chinese ENT Association,1997) There were 366 cases(28 9%) in type 1, 646 cases(50 9%) in type 2 and 256 cases(20 2%) in type 3 One thousand two hundred and sixty two cases underwent ESS under intranasal local anesthesia and sedation; 182 cases underwent submucous resection of nasal septum or septoplasty Long term follow up was performed at 9 to 42 months(mean=15 months). Results The results showed that cure rate was 93 7% for type 1, 81 6% for type 2 and 68 4% for type 3 There was significant difference in cure rate among different types ( P <0 01) Complication of ESS in 1 268 cases occurred in 2 3% Conclusion ESS is efficacy and safe in the treatment of nasal polyps and chronic sinusitis The cure result is directly related to the types of the disease