修正性鼻内镜手术疗效与影响因素

Efficacy and risk factors of revision endoscopic sinus surgery

目的分析修正性鼻内镜手术的临床疗效,了解其相关影响因素。方法对我院行修正性鼻内镜手术80例慢性鼻-鼻窦炎(chronic rhinosinusitis,CRS)患者临床资料进行回顾性分析,采用鼻内镜检查评分、CT检查评分及视觉模拟量表(visual analog scale,VAS)评分等进行疗效评定,分析手术临床疗效及影响因素。结果 80例CRS患者62例痊愈,11例好转,7例无效,总有效率为91.25%。单因素分析显示手术次数、鼻息肉史、变应性鼻炎史与随访依从性对手术疗效影响较大(P<0.05)。多因素Logistic回归分析显示,影响临床疗效的主要危险因素包括手术次数、变应性鼻炎史、VAS评分、鼻内镜检查评分、鼻息肉史、CT检查评分、鼻腔粘连和随访依从性(相对危险度1.4~2.8)。结论手术次数、变应性鼻炎史、鼻息肉史与随访依从性是影响修正性鼻内镜手术疗效的最关键因素。

OBJECTIVE To analyze the risk factors and clinical curative effect of revision endoscopic sinus surgery.METHODS The clinical data of the 80 patients underwent revision endoscopic sinus surgery were analyzed and the efficacy of the surgery was evaluated by the scores of the endoscopic examination,Lund-Mackay and VAS scoring system.Recovery rate and risk factors were observed and assessed.RESULTS In 80 patients,62 cases recovered,11 cases improved,7 cases were ineffective,and the total effective rate was 91.25%.Single factor analysis showed that operation frequency,follow-up compliance,history of allergic rhinitis and polyps effect on the clinical curative effect significantly(P<0.05).Multiple Logistic regression analysis showed that main risk factors affecting the curative effect were operation frequency,history of allergic rhinitis and polyps,follow-up compliance,VAS score,endoscopic examination scores,CT examination score,and nasal cavity adhesion(relative risk was between1.4-2.8).CONCLUSION Operation frequency,followup compliance,history of allergic rhinitis and polyps are important factors on curative effect of revision surgery.