鼻内镜手术82例术后复发原因的临床探讨

Clinical Study on Postoperative Recurrence Reasons of 82 Case of Nasal Endoscopic Surgery Patients

目的探讨鼻内镜手术术后复发的常见原因。方法回顾性分析2011-04/2013-08因在鼻内镜手术治疗后复发的82例慢性鼻窦炎再次手术的患者临床资料,总结鼻内镜手术术后复发的常见原因,并对再次手术效果进行探讨。结果导致鼻内镜手术术后复发的常见原因为：病灶未彻底清除,鼻窦口开放过大,术后未及时进行内镜复查,鼻内镜过勤复查,清理术腔不当等;82例鼻内镜手术术后复发患者再次手术,经0.5～1年在鼻内镜下定期术腔清理换药,75例患者痊愈,治愈率为91.5%。结论鼻内镜下将病变彻底清除,正规定期的术腔清理,保持术腔引流通畅,可使术腔的正常上皮化得到保证,有效提高手术成功率。

Objective To investigate the common causes of recurrence after endoscopic sinus surgery. Methods Clinical data of 82 patients conducted endoscopic sinus surgery due to postoperative recurrence during April 2011 to August 2013 were retrospectively analyzed. The common causes of recurrence after endoscopic sinus surgery were summarized and the re-surgical results were discussed. Results The common causes of recurrence after endoscopic sinus surgery were： focus not completely cleared,sinus mouth opened too wide,not timely review of endoscopic surgery,endoscopic reexamined too often,improper debridement cavity,etc. The 82 cases were conducted re-operation and after six months to one year regularly cleaning nasal cavity,75 cases were cured,with a cure rate 91. 5%. Conclusion By completely removing the lesion under endoscopic,regular periodic surgical cavity cleaning and maintaining surgical cavity unobstructed drainage,normal epithelium of the surgical cavity could be guaranteed and the success rate of surgery could be effectively improved.