RESS术与PESS术在慢性鼻-鼻窦炎伴鼻息肉患者治疗中的应用效果及对Lund-Kennedy评分法的影响

Effect of RESS and PESS in the Treatment of Chronic Rhinosinusitis with Nasal Polyp and the Influence on Lund-Kennedy Score

目的:探讨修正性鼻内镜鼻窦手术(RESS)与初次鼻内镜鼻窦手术(PESS)在慢性鼻-鼻窦炎伴鼻息肉患者治疗中的应用效果及对患者鼻内镜检查量化评估评分法(Lund-Kennedy评分法)的影响。方法:选取本院收治的慢性鼻-鼻窦炎伴鼻息肉患者78例。按照随机数表法将其分为研究组与对照组,各39例。对照组采用PESS术,研究组采用RESS术。比较两组术前及术后12个月时患者症状严重程度(Lund-Kennedy评分法)、影像学典型特征(Lund-Mackey CT评分)、疼痛程度(VAS评分)、鼻部症状(SNOT-20评分)、生活质量(SF-36评分),比较两组术后1个月内并发症发生情况。结果:术后12个月,两组Lund-Kennedy、Lund-Mackey CT、VAS、SNOT-20评分均较术前显著降低,且研究组Lund-Mackey CT评分低于对照组,差异均有统计学意义(P<0.05),但两组Lund-Kennedy、VAS、SNOT-20评分比较,差异均无统计学意义(P>0.05);术后12个月,两组SF-36各项评分均较术前显著升高(P<0.05),但两组SF-36各项评分比较,差异均无统计学意义(P>0.05);术后1个月内,两组眶周淤血、鼻腔粘连、泪道损伤发生率比较,差异均无统计学意义(P>0.05)。结论:RESS术应用于鼻-鼻窦炎伴鼻息肉可取得与PESS术同样的效果,改善患者鼻部症状、生活质量,降低疼痛感及术后并发症发生率。

Objective:To explore the effect of revision endoscopic sinus surgery(RESS)and primary endoscopic sinus surgery(PESS)in the treatment of patients with chronic rhinosinusitis and nasal polyps,and the influence of Lund-Kennedy scoring method.Method:A total of 78 patients with chronic rhinosinusitis and nasal polyp were selected.According to the method of random number table,they were divided into study group and control group,39 cases in each group.PESS was used in the control group and RESS was used in the study group.The symptom severity(Lund-Kennedy score),typical imaging features(Lund-Mackey CT Score),pain degree(VAS score),nose symptom(SNOT-20 score)and quality of life(SF-36 score)were compared before and 12 months after operation,the complications of the two groups were compared within one month.Result:At 12 months after operation,Lund-Kennedy,Lund-Mackey CT,VAS,and SNOT-20 scores in the two groups were significantly lower than those before operation,and Lund-Mackey CT scores in the study group was lower than that in the control group,the differences were statistically significant(P<0.05),but there were no significant differences in Lund-Kennedy,VAS and SNOT-20 scores between the two groups(P>0.05).At 12 months after operation,SF-36 scores in both groups were significantly higher than those before operation(P<0.05),but there were no significant differences in SF-36 scores between the two groups(P>0.05).Within one month after operation,there were no significant differences in the incidence of periorbital congestion,nasal adhesion and lacrimal duct injury between the two groups(P>0.05).Conclusion:The application of RESS in chronic rhinosinusitis with nasal polyp can achieve the same effect as PESS,improve the nasal symptoms,quality of life,reduce the incidence of pain and postoperative complications.