慢性鼻-鼻窦炎鼻内镜手术预后的影响因素分析

Analysis of the factors affecting the prognosis of functional endoscopic sinus surgery for chronic rhinosinusitis

目的分析影响慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)功能性鼻内镜手术(functional endoscopic sinus sur-gery,FESS)预后的因素,为术前评价和术后治疗提供依据。方法对有手术指征的59例CRS患者行术前检查,记录视觉类比法评分(visual analog scale,VAS)、鼻内镜评分、性别、年龄、血嗜酸性粒细胞数目以及是否合并哮喘、息肉资料。患者术后随访1年以上,共5次,每次随诊记录患者VAS及鼻内镜评分,根据结果判断手术预后,并进行影响预后的因素分析。结果血嗜酸性粒细胞数目增高,伴有哮喘的患者FESS预后差,其他因素不是影响FESS术后预后情况的主要因素。结论在所记录的指标中,血嗜酸性粒细胞数目增高,伴有哮喘评估手术效果意义重大,伴有息肉的CRS并不引起更差的手术效果,提示传统意义上的CRS的分型可能并不合理。

Objective To analyze the factors affecting the prognosis of functional endoscopic sinus surgery（FESS） for chronic rhinosinusitis（CRS） in order to provide the basis for preoperative evaluation and postoperative treatment. Methods The preoperative examinations were performed for fifty-nine patients with CRS including scores of visual analog scale （ VAS）, and nasal endoscopy, and gender, age, number of eosnophils, and whether or not combinated with asthma or nasal polyp. After the operation, the patients were followed-up for five times during the period of one year. The scores of VAS and nasal endoscopy were recorded. Factors affecting the prog- nosis were statistically analyzed. Results The increased number of blood esonophils and the combination with asthma had a negative effect on the prognosis of the operation while the other factors did not. Conclusions The number of blood esonophils and CRS combined with asthma are the major factors that affect the prognosis of FESS while CRS combined with nasal polyp had no significant effect. Therefore, the traditional classification of CRS may not be reliable.