不同类型鼻窦炎患者鼻内镜术后鼻腔功能及嗅觉改变的研究

Study on the changes of nasal function and sense of smell after nasal endoscopic surgery in patients with different types of sinusitis

目的 初步研究不同类型鼻窦炎患者接受鼻内镜下治疗后的疗效,观察其术后鼻腔功能、嗅觉改变和鼻窦黏膜形态的变化,评价术后效果。方法 选择2019年6月-2020年6月收治的100例鼻窦炎患者作为研究对象,根据病理检查结果将患者分为感染型组与变应型组,感染型组54例,变应型组46例,两组患者均行Messerklinger术,术后2个月评估两组患者的疗效、鼻气道阻力、鼻腔最小横截面至前鼻孔距离(DCAN)、鼻腔最小横截面积(NMCA)、鼻腔容积(NCV)、鼻腔鼻窦结局测试20量表中文版(SNOT-20 CV)评分、Lund-Kennedy鼻内镜评分和鼻黏膜病理形态。结果 两组患者均获得良好的治疗效果。其中,感染型组术后总有效率明显高于变应型组(P <0.01);感染型组患者术后的鼻气道阻力、DCAN、NCV和NMCA均较变应型组改善明显(P <0.05);感染型组SNOT-20 CV评分和Lund-Kennedy评分均低于变应型组(P <0.05);感染型组术后鼻黏膜形态改善较变应型组更明显(P <0.05)。结论 感染型患者的术后鼻腔功能、嗅觉及鼻黏膜形态恢复效果均优于变应型患者。感染型和变应型的鼻窦炎患者通过鼻内镜手术治疗后,均获得了良好效果,明显提高了患者生活质量,但不可忽视导致复发的变应性因素。

Objective To explore the efficacy of nasal endoscope in treatment of different types of sinusitis,observe the changes of nasal function,sense of smell and the morphology of paranasal sinus mucosa after operation,and evaluate the postoperative effect.Methods 100 patients with sinusitis were selected from June 2019 to June2020.According to the results of pathological examination,the patients were divided into infection group(n = 54)and allergic group(n = 46).Both groups were treated with Messerklinger.Two months after operation,the curative effect,nasal airway resistance,distance of minimal cross-section area from nostril(DCAN),nasal minimal crosssectional area(NMCA),nasal cavity volume(NCV),sino-nasal outcome test-20 Chinese Version(SNOT-20 CV)score,Lund-Kennedy score and pathological morphology of nasal mucosa were evaluated.Results Both groups achieved good therapeutic effect.Among of them,the total effective rate of the infection group was significantly higher than that of the allergy group(P < 0.01),the nasal airway resistance,DCAN,NCV and NMCA of the infection group were better than those of the allergy group(P < 0.05),SNOT-20 CV score and Lund-Kennedy score of the infection group were lower than those of the allergy group(P < 0.05),and the nasal mucosa morphology of the infection group was better than that of the allergy group(P < 0.05).Conclusion The postoperative nasal function,sense of smell and morphological recovery of nasal mucosa in infected patients are better than those in allergic patients.Both infective and allergic sinusitis patients achieved good results after endoscopic sinus surgery,which significantly improved the quality of life of the patients,but the allergic factors leading to recurrence should not be ignored.