鼻内镜下中鼻道开窗联合尖牙窝小视窗双径路术治疗真菌性鼻窦炎的效果

Nasal Endoscopic Middle Meatal Antrostomy Combined with Canine Fossa Dual Approach for Fungal Sinusitis

目的探讨鼻内镜下中鼻道上颌窦开窗术联合尖牙窝小视窗双径路术治疗真菌性鼻窦炎的临床效果。方法将78例真菌性鼻窦炎患者按治疗方法的不同分为对照组和观察组,每组39例。2组均采用鼻内镜下中鼻道上颌窦开窗术。在此基础上,观察组采用鼻内镜下尖牙窝小视窗双径路术。观察2组术后7d炎症指标[血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、C-反应蛋白(CRP)]的变化及术后1年复发率、临床疗效。结果观察组总有效率明显高于对照组(94.87%比79.49%,P<0.05)。观察组术后7d血清TNF-α、IL-6、IL-1β、CRP水平均明显低于对照组(均P<0.05)。观察组术后1年复发率明显低于对照组(7.69%比25.64%,P<0.05)。结论鼻内镜下中鼻道上颌窦开窗术联合尖牙窝小视窗双径路术治疗真菌性鼻窦炎具有较好的效果,能有效清除病灶,降低患者的炎症细胞因子水平和复发率。

Objective To explore the clinical effect of nasal endoscopic middle meatal antrostomy combined with canine fossa dual approach on fungal sinusitis.Methods Seventy-eight patients with fungal sinusitis were treated with nasal endoscopic middle meatal antrostomy alone(control group,n=39)or in combination with canine fossa dual approach(observation group,n=39).Serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)and Creactive protein(CRP)were measured postoperative 7 days.In addition,recurrence rates were determined 1 year after treatment.Results The total effective rate in observation group was significantly higher than that in control group(94.87% vs 79.49%,P<0.05).Furthermore,serum levels of TNF-,IL-6,IL-1 and CRP in observation group were obviously lower than those in control group postoperative 7 days(P<0.05).Moreover,postoperative 1-year recurrence rate in observation group was markedly lower than that in control group(7.69%to 25.64%,P<0.05).Conclusion Nasal endoscopic middle meatal antrostomy combined with canine fossa dual approach can effectively remove lesions andreduce inflammatory cytokine levels and recurrence rates in patients with fungal sinusitis.