慢性鼻-鼻窦炎患者鼻内镜手术后发生粘连的影响因素

Influencing Factors of Adhesion After Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis

目的探讨慢性鼻-鼻窦炎(CRS)患者鼻内镜手术后发生粘连的影响因素。方法选取2019年1月至2021年1月新郑市人民医院收治的380例CRS患者作为研究对象。患者均接受鼻内镜手术治疗。术后随访6个月,根据患者手术后粘连发生情况分为粘连组和未粘连组。调查并记录CRS患者基线资料,分析CRS患者鼻内镜手术后发生粘连的影响因素。结果380例CRS术后患者中41例(10.79%)发生粘连,纳入粘连组;339例未发生粘连,纳入未粘连组。粘连组术后鼻内感染、中鼻甲未处理、有变应性鼻炎(AR)病史患者占比高于未粘连组,血清血管内皮生长因子(VEGF)水平高于未粘连组(P<0.05)。logistic回归分析显示,术后鼻内感染、中鼻甲未处理、有AR病史、VEGF高表达是CRS患者鼻内镜手术后粘连发生的影响因素(OR>1,P<0.05)。结论术后鼻内感染、中鼻甲未处理、有AR病史、VEGF高表达是CRS患者鼻内镜手术后粘连发生的影响因素。

Objective To investigate the influencing factors of adhesion after endoscopic sinus surgery in patients with chronic rhinosinusitis(CRS).Methods A total of 380 patients with CRS treated in Xinzheng People’s Hospital from January 2019 to January 2021 were selected as the research objects.All patients were treated by endoscopic sinus surgery.They were followed up for 6 months.According to the occurrence of postoperative adhesion,they were divided into adhesion group and non adhesion group.The baseline data of CRS patients were investigated and recorded,and the influencing factors of adhesion after endoscopic sinus surgery were analyzed.Results Among 380 patients with CRS,41 cases(10.79%)developed adhesion after operation,which were included in the adhesion group,339 cases without adhesion were included in the non adhesion group.The proportion of patients with postoperative intranasal infection,untreated middle turbinate and history of allergic rhinitis(AR)in the adhesion group was higher than that in the non adhesion group,and the level of serum vascular endothelial growth factor(VEGF)was higher than that in the non adhesion group(P<0.05).Logistic regression analysis showed that postoperative intranasal infection,untreated middle turbinate,history of AR and high expression of VEGF were the influencing factors of adhesion after endoscopic sinus surgery in patients with CRS(OR>1,P<0.05).Conclusion Postoperative intranasal infection,untreated middle turbinate,history of AR and high expression of VEGF are the influencing factors of adhesion after endoscopic sinus surgery in patients with CRS.