鼻窦球囊扩张术治疗慢性蝶窦炎的临床观察

Clinical Observation of Balloon Sinuplasty for the Treatment of Chronic Sphenoid Sinusitis

目的评价鼻窦球囊扩张术治疗慢性鼻窦炎的临床疗效及安全性。方法 2011年11月-2013年3月17例慢性蝶窦炎患者行鼻窦球囊扩张术,术后随访12个月,观察患者的临床疗效。结果随访结束时,17例患者主观症状均有不同程度改善,鼻内镜检查见蝶窦口开放完好15例,窦口周围黏膜水肿1例,窦口狭窄1例;术后无视力改变、脑脊液鼻漏等其他并发症发生。视觉模拟评分术前为(5.21±1.51)分,术后3、6、12个月分别为(3.23±1.34)、(3.35±1.41)、(3.58±1.46)分;鼻窦结局测试-20量表中文版术前为(12.50±1.96)分,术后3、6、12个月分别为(7.30±1.79)、(7.64±1.93)、(7.77±2.02)分;Lund-Kennedy内镜黏膜形态评分术前为(3.51±1.47)分,术后3、6、12个月分别为(1.77±1.11)、(1.88±1.01)、(2.00±0.97)分;CT术前及随访结束时(12个月)得分分别为(1.57±1.06)、(0.85±0.62)分。术后各评分与术前比较,差异均有统计学意义(P<0.05)。结论鼻窦球囊扩张术治疗慢性蝶窦炎的临床疗效较好、安全性高,值得临床应用。

Objective To evaluate the safety and effect of balloon sinuplasty for the treatment of chronic sphenoid sinusitis. Methods From November 2011 to March 2013, 17 patients received balloon catheter dilation of sinus ostia. All the patients were followed up for 12 months postoperatively and the therapeutic effect was evaluated. Results At the end of the following-up, the clinical symptoms of all the patients got relieved. Through nasal endoscopic examination, we found that apertura sphenoidalis developed well in 15 cases, sinus mucosa edema in one case, sinus stenosis in one case, and no postoperative complications occurred. The mean visual analogue scale （VAS） scores were 5.21±1.51 preoperatively and 3.23 ± 1.34, 3.35 ± 1.41, 3.58± 1.46 at 3, 6 and 12 months postoperatively. The mean sino-nasal outcome test-20 scores were 12.50 ± 1.96 preoperatively and 7.30 ± 1.79, 7.64± 1.93, 7.77 ± 2.02 at 3, 6, 12 months postoperatively. The mean Lund-Kennedy endoscopic mucosal morphology scores were 3.51± 1.47 preoperatively and 1.77 ±1.11, 1.88 ± 1.01, 2.00 ± 0.97 at 3, 6, 12 months postoperatively. The mean CT scores were 1.57 ± 1.06 preoperatively and 0.85 ± 0.62 at 12 months postoperatively. Compared with the preoperative scores, the postoperative scores were significantly different. Conclusion Balloon sinuplasty is worthy of clinical application for its advantages of good clinical effect and safety.