慢性鼻-鼻窦炎鼻内镜术后并发症的危险因素及预防研究

Risk factors and prevention of complications after endoscopic sinus surgery for chronic rhinosinusitis

目的研究慢性鼻-鼻窦炎鼻内镜术后并发症的危险因素及预防策略,为并发症的预防提供参考。方法回顾性分析2019年1~12月深圳恒生医院耳鼻咽喉科诊治的85例慢性鼻-鼻窦炎患者的临床资料。所有患者均给予鼻内镜下手术治疗,根据患者术后是否出现并发症进行分组,其中11例术后出现并发症者纳入观察组,74例术后未出现并发症者纳入对照组。比较两组患者的临床资料,分析慢性鼻-鼻窦炎鼻内镜术后并发症的危险因素。结果观察组患者的男性比例、年龄、手术时间、病程、术中出血量明显高于或长于对照组,差异均有统计学意义(P<0.05);经多因素Logistic回归分析结果显示,术中出血量多、手术时间长、筛窦骨质增生、术前长时间口服抗凝药、鼻窦开放术腔创伤大、未行规范的围手术期处理是术后并发症的危险因素(P<0.05)。结论影响慢性鼻-鼻窦炎鼻内镜术后并发症的危险因素较多,术后加强随访,对鼻腔进行定期的清洗是预防并发症发生的策略。

Objective To study the risk factors and prevention strategies of complications after endoscopic sinus surgery for chronic rhinosinusitis.Methods The clinical data of 85 patients with chronic rhinosinusitis diagnosed and treated in Department of Otolaryngology,Shenzhen Hengsheng Hospital from January to December,2019 were analyzed retrospectively.All patients were treated by endoscopic surgery.According to whether there were complications after surgery,11 patients with complications were included in the study group,and 74 patients without complications were included in the control group.The clinical data of the two groups were compared,and the risk factors of complications after endoscopic sinus surgery were analyzed.Results The male ratio,age,operation time,course of disease,and intraoperative blood loss in the observation group were significantly higher than or longer than those in the control group(P<0.05).Multivariate logistic regression analysis showed that high intraoperative blood loss,long operation time,ethmoid sinus hyperosteogeny,oral anticoagulants for a long time before operation,large trauma of nasal sinus opening cavity,and lack of standardized perioperative management were the risk factors of postoperative complications(P<0.05).Conclusion There are many risk factors for complications after endoscopic sinus surgery for chronic rhinosinusitis.Strengthening follow-up after operation and regular cleaning of nasal cavity are the strategies to prevent complications.