哮喘对复发性鼻-鼻窦炎应用修正性鼻内镜手术治疗效果的影响分析

Analysis of the influence of asthma on the treatment outcome of recurrent rhinosinusitis with the application of revision endoscopic sinus surgery

目的分析哮喘对复发性鼻-鼻窦炎患者采取修正性鼻内镜手术治疗效果的影响。方法84例复发性鼻-鼻窦炎患者,根据是否伴有哮喘分为伴哮喘组和无哮喘组,每组42例。两组患者均采取修正性鼻内镜手术。比较两组患者对治疗效果的满意度及术前、术后1年的视觉模拟评分法(VAS)评分、Lund-Kennedy评分。结果无哮喘组患者对治疗效果的总满意率为95.24%(40/42),高于伴哮喘组的73.81%(31/42),差异具有统计学意义(P<0.05)。术后1年,两组患者VAS评分、Lund-Kennedy评分均低于本组术前,且无哮喘组患者VAS评分(0.82±0.73)分、Lund-Kennedy评分(1.39±1.20)分低于伴哮喘组患者的(1.66±1.17)、(2.78±1.83)分,差异具有统计学意义(P<0.05)。结论复发性鼻-鼻窦炎的发病主要与窦腔开放不全、局部解剖未矫正、增生粘连和变应性炎症等有关,采取修正性鼻内镜手术治疗效果明显,患者满意度高。但是,相对于伴有哮喘的患者,无哮喘患者的治疗效果更好,临床应用时应根据患者的具体情况选择治疗方法。

Objective To analyze the influence of asthma on the treatment outcome of recurrent rhinosinusitis with the application of revision endoscopic sinus surgery.Methods A total of 84 patients with recurrent rhinosinusitis were divided into asthma group and non-asthma group according to the presence or absence of asthma,with 42 patients in each group.Patients in both groups underwent revision nasal endoscopic surgery.The satisfaction with the treatment outcome and the visual analogue scale(VAS)score and Lund-Kennedy score before and 1 year after surgery were compared between the two groups.Results The satisfaction with the treatment outcome in the non-asthma group was 95.24%(40/42),which was higher than 73.81%(31/42)in the asthma group,and the difference was statistically significant(P<0.05).At 1 year after surgery,the VAS score and Lund-Kennedy score in both groups were lower than those before surgery in this group;the VAS score(0.82±0.73)points and Lund-Kennedy scores(1.39±1.20)points in the non-asthma group were lower than(1.66±1.17)and(2.78±1.83)points in the asthma group;the differences were statistically significant(P<0.05).Conclusion The development of recurrent rhinosinusitis is mainly related to incomplete sinus opening,uncorrected local anatomy,hyperplastic adhesions and allergic inflammation,etc.Revision endoscopic sinus surgery has obvious effects and high patient satisfaction.However,the treatment effect is better in patients without asthma compared to patients with asthma,and the treatment method should be selected according to the patient's specific situation when applied clinically.