功能性鼻内窥镜手术对慢性鼻窦炎患者CRP、TNF-α水平的影响及安全性分析

Effect of Functional Endoscopic Sinus Surgery on CRP and TNF-αin Patients with Chronic Sinusitis and its Safety Analysis

目的 探讨功能性鼻内窥镜手术对慢性鼻窦炎患者血清C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)水平的影响及安全性.方法 回顾性分析江苏省启东市中医院2017年1月至2019年1月收治的60例慢性鼻窦炎患者的临床资料,按手术方法 分为观察组与对照组,各30例.对照组患者予以传统手术治疗,观察组予以功能性鼻内窥镜手术治疗,术后2组均给予12周常规治疗.对比2组手术情况、术后临床效果和治疗期间并发症发生率,比较2组术前、术后12周血清CRP、TNF-α水平及临床症状、生活质量评分.结果 观察组患者手术治疗总有效率96.67%高于对照组80.00%;与术前相比,2组术后12周观察组血清CRP、TNF-α水平均降低,且观察组低于对照组(P<0.05);与对照组相比,观察组手术、住院时间缩短,术中出血量减少(P<0.05);与术前相比,术后12周2组嗅觉障碍、面部疼痛、鼻分泌物、头晕头痛及鼻腔鼻窦结局测量20条(SNOT-20)评分均降低,且观察组低于对照组(P<0.05);观察组术后并发症发生率10.00%低于对照组(30.00%,P<0.05).结论 功能性鼻内窥镜手术治疗可在一定程度上降低慢性鼻窦炎患者的血清CRP、TNF-α水平,改善临床症状,减少出血量,促使患者早日恢复,且安全性高,疗效显著,值得推广.

Objective To investigate the effect and safety of functional endoscopic sinus surgery on serum CRP and TNF-αin patients with chronic sinusitis.Methods The clinical data of 60 patients with chronic sinusitis admitted to Qidong Hospital of traditional Chinese medicine from January 2017 to January 2019 were analyzed retrospectively.According to the operation method,the patients were divided into observation group and control group,30 cases in each group.The patients in the control group were treated with traditional surgery,the patients in the observation group were treated with functional endoscopic surgery,and the patients in both groups were treated with routine therapy for 12 weeks.The changes of serum CRP,TNF-α,clinical symptoms and quality of life of the two groups before and 12 weeks after operation were compared.Results The total effective rate of surgical treatment in the observation group was 96.67%higher than that in the control group(80.00%).Compared with that before the operation,serum CRP and TNF-levels in the observation group of 12 weeks after the operation were all reduced,and the observation group was lower than the control group(P<0.05).Compared with the control group,the observation group had shorter operation and hospitalization time and less intraoperative blood loss(P<0.05).Compared with the preoperative results,20(SNOT-20)scores of olfaction disorders,facial pain,nasal secretions,dizziness and headache,and outcome of nasal and sinus outcomes were all decreased in the 2 groups 12 weeks after surgery,and the observation group was lower than the control group(P<0.05).The incidence of postoperative complications in the observation group was 10.00%lower than that in the control group(30.00%,P<0.05).Conclusion Functional endoscopic surgery can reduce the level of serum CRP and TNF-αin patients with chronic sinusitis to a certain extent,improve the clinical symptoms,reduce the amount of bleeding,and promote the early recovery of patients,with high safety and significant effect,which is worth promoting.