复发性鼻窦炎的修正性手术及综合治疗

Revison Endoscopic Sinus Surgery and Comprehensive therapy for Recurrent Sinusitis

目的探讨复发性鼻窦炎的修正性手术和综合治疗的临床疗效。方法回顾性分析38例复发性鼻窦炎手术治疗及综合治疗的临床资料,其中经鼻内镜鼻腔外侧壁切开上颌窦手术(ENLWD)2例,修正性鼻内额窦引流术8例,鼻内镜下根治性手术3例,其他行常规的息肉切除和鼻窦引流术,并且对所有病例行综合治疗。结果 38例患者均随访1年以上,其中24例治愈,好转8例,无效6例,治疗有效率为84.21%(32/38)。结论合理的围手术期处理,充分的术前准备,术中仔细的操作,术后认真随访,合理地清除术腔的息肉、囊泡是提高修正性鼻内镜手术疗效的关键因素。

Objective To investigate the effects of revison endoscopic sinus surgery and comprehensive therapy on recurrent sinusitis.Methods A retrospective analysis was performed in 38 patients with recurrent sinusitis.Among them,2 underwent endoscopic nasal lateral wall dissection,8 underwent endoscopic frontal sinus surgery,3 underwent endoscopic radical surgery and 25 underwent conventional polypectomy and sinus drainage.Moreover,all patients received comprehensive therapy.Results Patients were followed up for more than 1 year.Of the 38 patients,24 were successfully cured,8 showed improvement and 6 underwent ineffective therapy.The total effective rate was 84.21%（32/38）.Conclusion The efficacy of revison endoscopic sinus surgery can be greatly improved by reasonable perioperative treatment,adequate preoperative preparation,careful intraoperative approach,serious postoperative follow-up,and rational removal of the polyp and vesicle.