变应性因素对鼻内镜手术疗效的影响

Effects of allergic factors on endoscopic sinus surgery

目的：探讨变应性因素对慢性鼻窦炎伴鼻息肉患者行鼻窦内窥镜手术疗效的影响。方法对我院2011～2012年入院手术的II型慢性鼻窦炎伴鼻息肉患者，术前根据其是否伴有变应性鼻炎症状和体征、是否伴有过敏性疾病史及支气管哮喘病史、术前鼻腔分泌物涂片嗜酸粒细胞检查、变应原皮肤试验、血清特异性IgE检查、过敏性鼻炎，筛选出伴有变应性因素的慢性鼻窦炎伴鼻息肉患者为试验组。选择同期无变应性因素的单纯慢性鼻窦炎伴鼻息肉患者作为对照组。比较两组患者手术后疗效，并同时比较各种变应性因素对手术疗效的影响。结果伴有变应性因素的慢性鼻窦炎伴鼻息肉患者，手术疗效为80.95%（136/168），同期单纯慢性鼻窦炎伴鼻息肉患者，手术疗效为91.75%（189/206），两组间差异有显著性（P〈0.01）。在各种变应性因素中，伴有变应性鼻炎症状和体征、嗜酸粒细胞阳性、变应原皮肤试验阳性、血清特异性IgE、过敏性鼻炎的慢性鼻窦炎伴鼻息肉患者，与无变应性因素的慢性鼻窦炎伴鼻息肉患者比较，差异均有显著性（P〈0.05），伴有过敏性疾病史及伴支气管哮喘病史患者与无变应性因素的慢性鼻窦炎伴鼻息肉患者比较，差异无显著性（P〉0.05）。结论变应性因素与鼻窦内窥镜手术疗效密切相关，是术后复发的重要因素。对慢性鼻窦炎伴鼻息肉患者行鼻窦内窥镜手术时，必须加强围手术期抗变应性治疗。

Objective To explore the effects of allergic factors on endoscopic sinus surgery of chronic sinusitis and nasal polyps.Method Patients with chronic sinusitis and nasal polyps in Type Ⅱ in our Hospital from 2011 to 2012 were divided into two groups before the operation according to whether accompanied with allergic symptoms and syndrome or not, history of allergic disease and asthma, eosinophil in nasal secretions, allergen skin test, specific IgE（sIgE） in blood and allergic rhinitis. The treatment group has allergic factors while the control group has not. The results were compared between two groups. All of the cases were followed up from 6 months to 12 months.Results The effective rate in the treatment group was 80.95%（136/168）,while the control group was 91.75%（189/206）, which had a significant difference （P〈0.01）. In all kinds of allergic factors, patients with allergic symptoms and syndrome, eosinophil in nasal secretions, allergen skin test, specific IgE （sIgE） and allergic rhinitis compared to patients with no allergic factors respectively, all had significant difference （P〈0.01）. However, patients with history of allergic disease and asthma had no significant difference when compared with patients with no allergic factors （P〉0.05）.Conclusions Allergic factors are relative to the effects of endoscopic sinus surgery and allergic rhinitis is an important factor in the recurrence of chronic sinusitis and nasalpolyps. It is necessary to enhance treatment of ant-allergic rhinitis in perioperative period of chronic sinusitis and nasalpolyps.