慢性鼻-鼻窦炎患者应用鼻内窥镜手术治疗的有效性

The Effectiveness of Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis

目的分析在慢性鼻-鼻窦炎患者中应用鼻内窥镜手术治疗的有效性。方法于2018年8月—2019年8月方便择取该院诊治的138例慢性鼻-鼻窦炎患者,所选患者均实施鼻内窥镜手术治疗,分析患者手术治疗前后主要临床症状评分、鼻黏液纤毛清除功能、鼻内镜检查计分(Lund-Kennedy)结果、嗅觉功能评分、术后并发症发生情况。结果相比于术前,术后患者嗅觉障碍评分(1.87±0.33)分、面部疼痛评分(0.80±0.10)分、头痛评分(0.66±0.13)分、鼻塞评分(0.66±0.11)分、鼻分泌物评分(0.81±0.08)分均降低,差异有统计学意义(t=12.795、11.088、24.831、29.041、19.236,P<0.001);相比于术前,术后患者鼻黏液纤毛清除率(8.99±0.62)mm/min、鼻黏液纤毛清除率(79.33±6.39)%明显提高,糖精清除时间(20.11±1.02)min均缩短,差异有统计学意义(t=28.661、8.364、28.740,P<0.001);相比于术前,术后患者Lund-Kennedy评分(2.33±0.51)分明显下降,差异有统计学意义(t=12.852,P<0.001);相比于术前,术后患者嗅觉功能评分(6.78±0.44)分明显提高,差异有统计学意义(P<0.05);术后治愈患者93例、治疗有效患者25例、治疗无效患者20例,总有效率为85.50%。术后1例出现粘连现象,发生率为0.72%,1例出现鼻漏现象,发生率为0.72%,1例出现眼眶淤血现象,发生率为0.72%,总发生率为2.17%。结论在慢性鼻-鼻窦炎患者中,鼻内窥镜手术的实施可以取得良好效果,不仅可以改善临床症状,还可以使鼻黏液纤毛清除功能得到改善,提高嗅觉功能,减少并发症发生,具有显著临床价值。

Objective To analyze the effectiveness of endoscopic sinus surgery in patients with chronic rhinosinusitis.Methods From August 2018 to August 2019,138 patients with chronic rhinosinusitis treated in the hospital were convenient selected.The selected patients were treated with endoscopic sinus surgery.The scores of main clinical symptoms and nasal mucociliary clearance were analyzed before and after surgery,nasal endoscopy score(Lund-Kennedy)results,olfactory function score,postoperative complications.Results Compared with preoperative,postoperative patients’olfactory dysfunction score(1.87±0.33)points,facial pain score(0.80±0.10)points,headache score(0.66±0.13)points,nasal congestion score(0.66±0.11)points,nasal secretions The scores(0.81±0.08)points were all decreased,and the difference was statistically significant(t=12.795,11.088,24.831,29.041,19.236,P<0.001);compared with preoperative,postoperative nasal mucociliary clearance rate(8.99±0.62)mm/min,nasal mucociliary clearance rate(79.33±6.39)%was significantly improved,saccharin clearance time(20.11±1.02)min were shortened,the difference was statistically significant(t=28.661,8.364,28.740,P<0.001);Compared with preoperative,postoperative patients’Lund-Kennedy score(2.33±0.51)points significantly decreased,the difference was statistically significant(t=12.852,P<0.001);compared with preoperative,postoperative patients’smell The functional score(6.78±0.44)points was significantly improved,and the difference was statistically significant(P<0.05);93 patients were cured after surgery,25 patients were treated effectively,and 20 patients were ineffective.The total effective rate was 85.50%.Postoperative adhesions occurred in 1 case,the incidence was 0.72%,1 case had rhinorrhea,the incidence was 0.72%,and 1 case had orbital congestion,the incidence was 0.72%,and the total incidence was 2.17%.Conclusion In patients with chronic rhinosinusitis,the implementation of nasal endoscopic surgery can achieve good results.It can not only improve clinical symptoms,but also improve nasal mucociliary clearance,improve olfactory function,and reduce complications,with significant clinical value.