鼻内镜下上颌窦开放术联合下鼻道开窗术治疗真菌性鼻窦炎患者的效果

Effects of endoscopic maxillary sinus opening combined with inferior meatus fenestration in treatment of patients with fungal sinusitis

目的:观察鼻内镜下上颌窦开放术联合下鼻道开窗术治疗真菌性鼻窦炎(FRS)患者的效果。方法:选取98例FRS患者为研究对象,依照随机数字表法分为对照组和观察组各49例。对照组采用鼻内镜下上颌窦开放术治疗,观察组采用鼻内镜下上颌窦开放术联合下鼻道开窗术治疗。比较两组临床疗效、手术前后临床症状的视觉模拟评分法(VAS)评分、Lund-kennedy评分、生命质量[鼻腔鼻窦结局测试20(SNOT-20)评分]和并发症发生率。结果:观察组治疗总有效率为97.96%(48/49),高于对照组的77.55%(38/49),差异有统计学意义(P<0.05);术后1个月,观察组鼻塞、头痛、流脓涕、嗅觉减退等临床症状VAS评分均低于对照组,差异有统计学意义(P<0.05);术后3个月,观察组Lund-kennedy、SNOT-20评分均低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:鼻内镜下上颌窦开放术联合下鼻道开窗术治疗FRS患者,可提高治疗总有效率,有效改善患者临床症状,恢复鼻黏膜形态,提高其生命质量,效果优于鼻内镜下上颌窦开放术治疗,且安全性良好。

Objective:To observe effects of endoscopic maxillary sinus opening combined with inferior meatus fenestration in treatment of patients with fungal sinusitis(FRS).Methods:98 FRS patients were selected as the research objects,and were divided into control group and observation group according to the random number table method,each with 49 cases.The control group was treated with endoscopic maxillary sinus opening,while the observation group was treated with endoscopic maxillary sinus opening combined with inferior meatus fenestration.The clinical efficacy,the improvement of clinical symptoms before and after the surgery[visual analog scale(VAS)score],the Lund-kennedy score,the quality of life[nasal cavity and sinus outcome test 20(SNOT-20)score]and the incidence of complications were compared between the two groups.Results:The total effective rate of treatment in the observation group was 97.96%(48/49),which was higher than the control group of 77.55%(38/49),and the difference was statistically significant(P<0.05).One month after the surgery,the VAS scores of clinical symptoms such as nasal congestion,headache,runny nose,and hyposmia in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Three months after the surgery,the Lund-kennedy score and SNOT-20 score of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).However,there was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:Endoscopic maxillary sinus opening combined with inferior meatus fenestration in the treatment of the patients FRS patients can increase the total effective rate of treatment,effectively improve the clinical symptoms,restore the morphology of the nasal mucosa,and improve their quality of life with good safety.Moreover,it is superior to endoscopic maxillary sinus opening.