伴嗅觉障碍的慢性鼻-鼻窦炎患者术后嗅觉变化的临床研究

Clinical studies on postoperative olfactory changes in chronic sinusitis patients with olfactory dysfunction

目的研究慢性鼻-鼻窦炎(CRS)手术与嗅觉功能之间的关系.方法2014年10~12月在吉林大学中日联谊医院耳鼻咽喉头颈外科治疗的48例CRS且嗅觉障碍患者,行鼻内镜下鼻窦开放手术治疗,对比手术前、后1个月的嗅觉变化.结果①嗅觉障碍较术前提升的患者45例,其中显著改善20例,改善19例,嗅觉完全恢复6例,无改善3例,无嗅觉减退者.②术前伴有鼻息肉的患者中5%嗅觉恢复正常,16%显著改善,68%改善,11%无改善;术前不伴有鼻息肉的患者中17%嗅觉恢复正常,59%显著改善,21%改善,3%无改善.③40岁以下的患者中16%嗅觉恢复正常,60%显著改善,24%改善;40岁以上的患者中9%嗅觉恢复正常,22%显著改善,56%改善,13%无改善.④男性患者中14%嗅觉恢复正常,46%显著改善,32%改善,7%无改善;女性患者中10%嗅觉恢复正常,35%显著改善,50%改善,5%无改善.结论①鼻内镜手术治疗CRS可有效改善患者的嗅觉功能;②伴发鼻息肉、年龄是鼻内镜术后嗅觉恢复的影响因素(P<0.05),性别不是影响鼻内镜术后嗅觉恢复的因素(P>0.05).

Objective Explore the relationship between operation and olfactory function of chronic rhinosinusitis(CRS).Methods 48 cases of CRS patients with olfactory dysfunction were treated by endoscopic sinus surgery in China-Japan Hospital of Jilin University between October to December 2014,comparing the olfactory changes of them before and one month after operation.Results 1.There are 45 cases with improvement of olfactory dysfunction after surgery,and 20 cases with significant improvement,19 cases improved,6 cases returned to normal,3 cases had not improvement at all,and no olfactory hypothyroidism after surgery.2.5% of the patients with nasal polyps before surgery recovered their olfactory function,16% improved significantly,68% improved,11% didn't improve;17% of the patients without nasal polyps before surgery recovered their olfactory function,59% improved significantly,21% improved,3% didn't improve.3.16% of the patients under 40 years old recovered their olfactory function,60% improved significantly,24% improved;9% of the patients above 40 recovered their olfactory function,22% improved significantly,56% improved,13% didn't improve.4.14% of male patients recovered their olfactory function,46% improved significantly,32% improved,7% didn't improve;10% of female patients recovered their olfactory function,35%improved significantly,50% improved,5% didn't improve.Conclusion 1.Endoscopic surgery for CRS can effectively improve the olfactory function of patients.2.Nasal polyps and age were the influence factors of olfactory recovery after endoscopic surgery(P<0.05);Sex was not the influence factor of olfactory recovery after endoscopic surgery(P>0.05).