老年慢性鼻-鼻窦炎伴鼻息肉患者鼻内镜术后复发的影响因素分析

Analysis of the influencing factors of recurrence for elderly patients with chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery

目的探讨老年慢性鼻-鼻窦炎伴鼻息肉(chronic rhinosinusitis with or without nasal polyps,CRSwNP)患者鼻内镜术后复发的影响因素。方法行鼻内镜治疗的老年CRSwNP患者126例,根据是否复发分为复发组(52例)和未复发组(74例),对可能影响其术后复发的相关因素进行分析。结果老年CRSwNP患者鼻内镜术后1年复发率为41.3%。单因素分析:支气管哮喘史、长期应用鼻减充血剂、Lund-Mackay评分、症状视觉模拟量表评分、嗜酸性粒细胞型鼻息肉、术后坚持综合治疗在两组间比较有统计学差异(P均<0.05)。logistic回归分析:嗜酸性粒细胞型鼻息肉、Lund-Mackay评分、长期应用鼻减充血剂是老年CRSwNP患者鼻内镜术后复发的独立危险因素,术后坚持综合治疗是其保护性因素。结论老年CRSwNP患者鼻内镜术后复发受多种因素影响,临床工作中应针对相应影响因素给予积极干预,以减少术后复发。

OBJECTIVE To explore the influencing factors of recurrence for elderly patients with chronic rhinosinusitis with nasal polyps(CRSwNP)after endoscopic sinus surgery.METHODS 126 elderly patients with CRSwNP who treated by endoscopic sinus surgery were divided into recurrence group(52 cases)and non-recurrence group(74 cases)according to the recurrence.The influencing factors for recurrence were analyzed by multivariate logistic regression.RESULTS The recurrence rate of elderly patients with CRSwNP was 41.3%at one year after endoscopic sinus surgery.The univariate analysis showed that there were significant differences in bronchial asthma,using nasal decongestants,Lund-Mackay score,visual analogue scale,eosinophil nasal polyps,comprehensive treatments after surgery between two groups(P<0.05).Multivariate logistic regression analysis revealed that eosinophil nasal polyps,Lund-Mackay score,using nasal decongestants were the independent risk factors for recurrence,and comprehensive treatments after surgery was the protective factor.CONCLUSION There are a variety of influencing factors for recurrence after endoscopic sinus surgery in elderly patients with CRSwNP.It is necessary to take targeted intervention measures in response to the influencing factors so as to reduce the incidence of recurrence.