内窥镜鼻窦手术联合中鼻甲切除术治疗难治性鼻窦炎效果观察

Clinical effect of endoscopic sinus surgery combined with middle turbinate resection on refractory sinusitis

目的分析内窥镜鼻窦手术联合中鼻甲切除术治疗难治性鼻窦炎（Rs）的临床效果。方法选择78例难治性鼻窦炎患者，以随机数字表法分为观察组和对照组，对照组39例采用内窥镜鼻窦手术治疗，观察组39例在对照组基础上联合中鼻甲切除术治疗。统计两组术后6个月总有效率、复发率、并发症发生率，并对比两组Lund—Kennedy评分、鼻腔鼻窦结局评分表（SNOT一20）。结果术后6个月，观察组总有效率[89．74％（35／39）]高于对照组[69．23％（27／39）]，差异有统计学意义（P〈0．05）；与术前相比，两组术后6个月Lund—Kennedy与SNOT-20评分均降低，且观察组降低程度较对照组明显，差异有统计学意义（P〈0．05）；观察组复发率（2．56％）低于对照组（20．51％），差异有统计学意义（P〈0．05）；观察组并发症发生率（10．26％）与对照组（5．13％）相比，差异未见统计学意义（P〉0．05）。结论难治性鼻窦炎采用内窥镜鼻窦手术联合中鼻甲切除术治疗，可显著改善患者临床症状，减少术后复发，疗效显著，且安全性高。

Objective To analyze the clinical effect of endoscopic sinus surgery combined with middle turbinate resection on refractory sinusitis （ RS）. Methods A total of 78 patients with refractory sinusitis were divided into observation group and control group by random number table method. Thirty- nine patients in control group were treated by endoscopic sinus surgery, and 39 patients in the observation group were given middle turbinate resection in addition. The total effective rates, recurrence rates, incidences of complications were compared between the two groups after 6 months, the Lund-Kennedy scores, and the scores of the nasal cavity and nasal sinuses （SNOT-20） of the two groups were com- pared. Results After 6 months, the total effective rate of the observation group was 89.74% （35/39） , which was higher than that of the control group （69.23 % ,27/39 ）, the difference was significant （ P 〈 0.05）. Compared with the preoperative, Lund-Kennedy and SNOT-20 scores of the two groups after 6 months were lower, and the observation group was significantly lower than the control group, the difference was significant （P 〈 0.05）. The recurrence rate of the observation group was 20.51% , which was lower than that of the control group （2.56%）, the difference was significant （P 〈0. 05 ）. There was no significant difference in the incidence of complications between the observation group and the control group （10.26% vs 5.13% , P 〉 0.05）. Conclusions The treatment of refractory sinusitis by endoscopic sinus surgery combined with middle turbinate resection can significantly improve the clinical symptoms, and it can reduce the recurrence, the curative effect is remarkable, and the security is high.