不同年龄段慢性鼻-鼻窦炎伴鼻息肉患者功能性鼻内镜手术后黏膜转归分析

The outcomes of sinonasal mucosa in different age groups of patients with chronic rhinosinusitis with nasal polyps after functional endoscopic nasal surgery

目的探讨不同年龄段双侧慢性鼻-鼻窦炎伴鼻息肉患者功能性鼻内镜手术后黏膜转归规律的差异。方法将84例双侧慢性鼻-鼻窦炎伴鼻息肉患者按年龄分为青少年组20例,成人组48例,老年组16例,在实施功能性鼻内镜手术后的第1周、第1个月、第3个月、第6个月、第12个月,采用Lund-Kennedy内镜评分方法对双侧术腔进行评分,比较不同年龄段不同时期的鼻腔鼻窦黏膜形态的评分分值和完成上皮化比例。结果术后第1周,三组患者黏膜评分比较,差异无统计学意义(F=0.81,P>0.05);术后第1个月、第3个月,青少年组的黏膜评分高于成年组、老年组(P<0.05);术后第6个月、第12个月,三组的黏膜评分比较,差异无统计学意义(F=1.4,P>0.05)。术后1年青少年组、成年组、老年组完成上皮化分别为10例(50.0%)、36例(75.0%)、14例(87.5%),三组比较,差异有统计学意义(χ2=6.72,P<0.05),青少年组完成上皮化比例低于成年组及老年组。结论不同年龄阶段慢性鼻-鼻窦炎伴鼻息肉患者功能性鼻内镜术后鼻腔鼻窦黏膜转归有明显差异;术后1年青少年患者完成上皮化比例较成年、老年患者低。

Objective To explore the difference of sinonasal mucosa outcomes in different age groups of patients with chronic bilateral rhinosinusitis with nasal polyps after functional endoscopic nasal surgery. Methods 84 patients diagnosed as chronic bilateral rhinosinusitis with nasal polyps were divided into adolescent group（ n = 20）, adult group （n = 48 ） and elderly group （n = 16）. All of cases were assessed in bilateral lesions using Lund- Kennedy endoscopic scoring system in the first week, first month, third month, sixth month and 12th month after surgery. Comparison about endoscopic appearances scores and epithelialization proportion of sinonasal mucosa was performed in three groups. Results There was no difference about the endoscopic appearances scores in three groups in the first week after surgery（F =0.81 ,P 〉0.05）. And the scores in adolescent group were higher than in the adult group or the elderly group in first and third month after surgery （P 〈0.05）. The scores of the sixth month and 12th month after surgery had no difference in three groups （F = 1.4, P 〉 0.05）. The epithelialization proportions one year after surgery in the adolescent group, the adult group and the elderly group were 50% ,75% ,87.5%, respectively （ X2 = 6.72, P 〈 0.05 ）. The epithelialization proportion in the adolescent group was lower than in the adult group or the elderly group. Conclusions The outcomes of sinonasal mucosa mucosa in patients with chronic rhinosinusitis with nasal polypus after functional endoscopic nasal surgery differ significantly in different age groups. The epithelialization proportion in the adolescent patients was lower than in the adult or elderly patients one year after surgery.