鼻内镜手术和柯陆手术治疗真菌性鼻-鼻窦炎的疗效比较及炎症因子分析

comparision of the effects between endoscopic sinus surgery and CaldwellLu'surgery and the inflammatory factor on patients with fungal rhino-sinustis

目的比较鼻窦镜手术和传统柯陆氏手术治疗真菌性鼻-鼻窦炎的疗效以及术后患者炎症反应的差异。方法取我院2013年12月至2015年12月收治的76例患者作为研究对象,,随机分入鼻内镜手术治疗组(观察组)和传统柯陆氏手术治疗组(对照组),每组38例。其中观察组于鼻窦镜下行Messerklinger手术治疗,对照组行传统Caldwell Luc手术治疗。随访6个月,判断并比较两组手术疗效,检测并比较手术前后炎症细胞因子的变化。结果两组手术总有效率比较无统计学差异(P>0.05),观察组术后半年内复发率为0%,明显低于对照组的10.53%(P<0.05)。观察组鼻腔黏膜肿胀、涕中带血、局部感染、牙痛、面部疼痛麻木发生率,均显著低于对照组(P<0.05)。两组术后血清IL-4、IL-6、IL-12、Hs-CRP水平均较术前有显著下降(P<0.01),但观察组下降更为明显(P<0.01)。结论鼻窦镜手术治疗真菌性鼻-鼻窦炎可有效减轻患者术后炎症细胞因子水平,且不良反应明显减轻。

Objective To compare the effects of endoscopic sinus surgery and CaldwellLu＇ surgery and the inflammatory factor on patients with fungal rhino-sinustis. Methods 76 patients with fungal rhino-sinustis treated in our hospital from December 2013 to December 2015 were selected. The patients were randomly divided into endoscopic surgery group （observation group） and traditional CaldwellLu＇ surgery group （control group）, 38 cases in each group. The Messerklinger surgery treatment was given for the patients in the observation group and the CaldwellLuc surgery treatment was given for the control group. The curative effect of operation, the preoperative and postoperative inflammatory factors in the two groups were compared. Results It showed no significantly difference in the total effective rate of surgery between the two groups （P〉0.05）. The recurrence rate in half year after surgery was 0% in the observation group which was obviously lower than that in the control group was 10.53%. The incidence of the nasal mucosal swelling, bloody nasal mucus, local infection, toothache, facial pain and numbness was obviously lower than that in the control group （P〈0.05）. After surgery, the serum IL-4, IL-6, IL-12 and Hs-CRP levels of patients in the two groups decreased significantly （P〈0.01）, while the observation group decreased more obviously （P〈0.01）. Conclusion Endoscopic sinus surgery in the treatment of fungal rhino- sinustis can effectively reduce the level of postoperative flammatory factor, and significantly reduce adverse reaction.