鼻窦球囊导管扩张术联合纤维鼻咽喉镜治疗鼻窦囊肿的效果

Treatment of nasal sinus cyst by nasal sinus balloon dilatation combined with nasopharyngeal laryngoscope

目的探讨鼻窦球囊导管扩张术联合纤维鼻喉镜治疗鼻窦囊肿的临床效果。方法选取2014年1月‐2016年1月收治的鼻窦囊肿患者70例,按照治疗方法的差异将患者分为观察组与对照组,每组患者35例。其中对照组患者以常规鼻内镜鼻窦手术进行治疗,观察组患者以鼻窦球囊导管扩张术联合纤维鼻喉镜进行治疗,记录手术时间;视觉模拟量表(VAS)评估手术难易度,分值越高,难度越大;鼻镜检查结果采用内镜黏膜形态评分表(L-K)评估内镜黏膜形态。结果观察组手术难易度评分高于对照组,手术时间长于对照组,差异有统计学意义(P<0.05)。观察组术后24周L-K内镜黏膜形态评分明显低于对照组,差异有统计学意义(P<0.05)。观察组术后CT扫描上颌窦病变范围小于对照组,差异有统计学意义(P<0.05);观察组患者术后1周、4周时的视觉模拟量表(VAS)评分低于对照组,组间比较差异具有统计学意义(P<0.05)。结论鼻窦球囊导管扩张术联合纤维鼻喉镜治疗鼻窦囊肿具有较好的临床效果,但该项手术具有一定的复杂性,对于医师技术水平要求较高。

[Objective] To investigate the clinical effect of nasal sinus balloon dilatation combined with fiber laryngoscopy in the treatment of sinus cyst. [Methods] Seventy patients with sinus cysts admitted in our hospital from January 2014 to January 2016 were divided into observation group and control group according to the difference in treatment methods, with 35 cases in each group. The patients in the control group were treated with conventional endoscopic sinus surgery. The patients in the observation group were treated with sinus balloon catheter dilatation combined with fiber laryngoscopy. The operative time was recorded. The difficulty of the surgery was evaluated by the visual analogue scale （VAS）. The higher the value, the greater the difficulty. Endoscopic mucosal morphology was assessed using the Lund-Kennedy scale. [Results] The score of operation difficulty of the observation group was higher than that of the control group, and the operation time was longer than that of the control group, and the differences were statistically significant （P 〈0.05）. The Lund-Kennedy endoscopic mucosal morphology score of the observation group was significantly lower than that of the control group at the 24th week after operation （P 〈0.05）. The lesion range of maxillary sinus scanned by computed tomography of the observation group was smaller than that of the control group （P 〈0.05）. The VAS score of the observation group was lower than that of the control group at the first week and fourth week after operation, and the difference between the two groups was statistically significant （P 〈0.05）. [Conclusion] Sinus balloon dilatation combined with fiber laryngoscopy is a good method for the treatment of sinus cyst. However, this procedure is complicated and requires a high level of physician skill.