鼻内镜修正性手术联合中鼻甲切除治疗难治性鼻-鼻窦炎的临床效果

Clinical effect of modified endoscopic sinus surgery combined with middle turbinectomy in the treatment of refractory rhinosinusitis

目的评价鼻内镜修正性手术联合中鼻甲切除治疗难治性鼻-鼻窦炎(RRS)的临床效果。方法将我院2016年1月至2018年2月收治的114例RRS患者根据治疗方法不同分为对照组和观察组,每组57例。对照组患者采用常规手术治疗,观察组患者采用鼻内镜修正性手术联合中鼻甲切除治疗。比较两组患者治疗前和治疗后(术后6个月末次随访时)的临床症状评分、生活质量评分、临床疗效、并发症及复发情况。结果治疗前,两组患者的鼻塞、脓涕、嗅觉障碍、疼痛评分及生活质量评分比较,差异无统计学意义(P>0.05);治疗后,两组患者的鼻塞、脓涕、嗅觉障碍、疼痛评分及生活质量评分均低于治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05);观察组患者的治疗总有效率为91.23%,显著高于对照组的71.93%,差异具有统计学意义(P<0.05);观察组患者的并发症总发生率及复发率均显著低于对照组,差异具有统计学意义(P<0.05)。结论修正性鼻内镜手术联合中鼻甲切除治疗RRS的效果显著,可有效改善患者的临床症状及生活质量,且术后并发症少,复发率低,值得临床推广应用。

Objective To evaluate the clinical effect of modified endoscopic sinus surgery combined with middle turbinectomy in the treatment of refractory rhinosinusitis (RRS). Methods A total of 114 RRS patients admitted in our hospital from January 2016 to February 2018 were divided into control group and observation group according to different treatment methods, with 57 cases in each group. The control group was treated with routine surgery, while the observation group was treated with modified endoscopic sinus surgery combined with middle turbinectomy. The clinical symptom scores, quality of life scores before treatment and after treatment (at the last follow-up of 6 months after operation), clinical effects, complications and recurrence between the two groups were compared. Results Before treatment, there were no significant differences in the scores of nasal obstruction, purulent nasal discharge, olfactory disturbance, pain and quality of life between the two groups (P>0.05). After treatment, the scores of nasal obstruction, purulent nasal discharge, olfactory disturbance, pain and quality of life in the two groups were lower than those before treatment, and those in the observation group were lower than the control group, the differences were statistically significant (P<0.05). The total effective rate of treatment in the observation group was 91.23%, which was statistically higher than 71.93% in the control group, the difference was statistically significant (P<0.05). The total incidence and recurrence rate of complications in the observation group were lower than those in the control group, the differences were statistically significant (P<0.05). Conclusion Modified endoscopic sinus surgery combined with middle turbinectomy in the treatment of RRS has significant effect, it can effectively improve the clinical symptoms and quality of life, and has fewer complications and lower recurrence rate, which is worthy of clinical promotion and application.