鼻内镜下双路径联合治疗上颌窦出血坏死性息肉的疗效对比分析

The compared analysis of the therapeutic effects of double pathway under nasal endoscope for patients with maxillary sinus hemorrhagic and necrotic polyps

目的探讨鼻内镜下双路径联合治疗上颌窦出血坏死性息肉的疗效。方法收集鼻内镜下经自然窦口联合柯-陆氏手术治疗上颌窦出血坏死性息肉患者24例作为联合组,采用传统柯-陆氏手术治疗18例作为传统组。比较两组患者术后并发症、主观症状评分(VAS)、手术疗效、术后复发情况。结果联合组并发症发生率(16.7%)与传统组(44.4%)相比,差异有统计学意义(χ2=3.889;P=0.049)。术前两组患者VAS差异均无统计学意义(P>0.05)。术后1周、1个月联合组各症状评分显著低于传统组,差异有统计学意义(P<0.01);术后3个月,各组症状均基本消失,两组相比差异无统计学意义(P>0.05)。各组手术时间、治愈率相比差异无统计学意义(P>0.05),但住院时间联合组较传统组显著缩短,差异有统计学意义(F=4.568,P<0.05)。联合组术后复发率为0.0%,显著低于传统组(16.7%),差异有统计学意义(χ2=4.308;P=0.038)。结论通过扩大的自然窦口进镜联合柯-陆氏手术内镜下治疗上颌窦出血坏死性息肉与传统柯-陆氏手术相比,具有创伤小、术后症状缓解快、并发症少、复发率低的优势。

Objective To explore the therapeutic effects of double pathway under nasal endoscope for patients with maxillary sinus hemorrhagic and necrotic polyps.Methods 24 patients with maxillary sinus hemorrhagic and necrotic polyps accepted endoscopic surgery united with Caldwell-Luc operation were selected as united group;and 18 patients arranged classic Caldwell-Luc operation were regarded as classic group.The complications,subjective symptom score（VAS）,therapeutic effects and recurrence post operation were compared.Results The incidence rate of complication in united group（16.7%） was obviously different to classic group（44.4%）（χ2=3.889;P=0.049）.The symptoms score was not different before operation.After one week and one month of the operation,the VAS was lower in united group than classic group（P0.01）.Until 3 months after operation,the VAS was not different in the two groups.There was no difference of operation time and recovery rate in the two groups,but the length of stay in hospital was significantly shorter for united group compared to classic group（F=4.568,P0.05）.The recurrence rate of united group post-operation（0.0%） was obviously lower than classic group（16.7%）（χ2=4.308;P=0.038）.Conclusion Compared with the tranditional Caldwell Luc operation,the operation of nasal endoscope united with Caldwell-Luc operation has less wound,quick symptomatic relief,less complications and lower recurrence rate for patients with maxillary sinus hemorrhagic and necrotic polyps.