慢性鼻-鼻窦炎伴鼻息肉患者鼻内镜术后鼻息肉复发的影响因素分析

Analysis of factors influencing the recurrence of nasal polyps in patients with chronic rhinosinusitis and nasal polyps after nasal endoscopy

目的探究慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)患者鼻内镜术后鼻息肉复发的影响因素。方法回顾性分析2017年10月至2019年3月本院收治的82例CRSwNP患者的临床资料,所有患者均行鼻内镜手术治疗,分析患者术后1年鼻息肉复发情况,采用单因素分析影响CRSwNP患者鼻内镜术后鼻息肉复发因素。结果80例CRSwNP患者中,术后复发鼻息肉20例,未复发62例。复发患者哮喘史、嗜酸粒细胞(EOS)浸润型鼻息肉、病灶清除不彻底、长期使用鼻减充血剂、术后无辅助治疗发生率高于未复发患者,差异有统计学意义(P<0.05),复发患者与未复发患者性别、年龄、饮酒史、吸烟史、鼻窦炎手术史、变应性鼻炎病史、鼻中隔偏曲、术腔粘连比较差异无统计学意义;哮喘史、EOS型鼻息肉、病灶清除不彻底、长期使用鼻减充血剂均是CRSwNP患者鼻内镜术后鼻息肉复发的独立危险因素(OR>1,且P<0.05);术后辅助治疗是CRSwNP患者鼻内镜术后鼻息肉复发的保护因素(OR<1,P<0.05)。结论伴有哮喘史、EOS浸润型鼻息肉、病灶清除不彻底、长期使用鼻减充血剂是CRSwNP患者术后复发的危险因素,术后辅助治疗是其保护因素,在临床干预中需给予重视,以改善患者预后。

Objective To investigate the factors affecting the recurrence of nasal polyps in patients with chronic rhinosinusitis associated with na-sal polyps(CRSwNP)after nasal endoscopic surgery.Methods Clinical data of 82 patients with CRSwNP admitted to our hospital from October 2017 to March 2019 were retrospectively analyzed,all patients were treated with nasal endoscopic surgery,and the recurrence of nasal polyps one year after surgery was analyzed.The factors influencing the recurrence of nasal polyps in patients with CRSwNP after nasal endoscopic surgery were analyzed by single factor analysis.Results Of the 80 patients with CRSwNP,20 cases had recurrent nasal polyps and 62 cases without recurrent.The incidence of asthma history,eosinophil(EOS)infiltrating nasal polyp,incomplete removal of lesion,long-term use of nasal decongestant,and no postoperative adjuvant treatment of patients with recurrent were higher than those of patients without recurrent,the difference was statistically signifi-cant(P<0.05).There were no significant differences in gender,age,drinking history,smoking history,sinus surgery history,allergic rhinitis history,nasal septum deviation and intraoperative cavity adhesion between patients with recurrent and without recurrent.History of asthma,EOS type nasal polyp,incomplete removal of lesions,and long-term use of nasal decongestants were all independent risk factors for nasal polyp recurrence in pa-tients with CRSwNP after nasal endoscopic surgery(OR>1,P<0.05).Postoperative adjuvant therapy is a protective factor for the recurrence of na-sal polyps in patients with CRSwNP after nasal endoscopic surgery(OR<1,P<0.05).Conclusion History of asthma,EOS invasive nasal polyps,incomplete removal of lesions,and long-term use of nasal decongestants are risk factors for postoperative recurrence in patients with CRSwNP,and postoperative adjuvant therapy is a protective factor.Attention should be paid to clinical intervention in order to improve the prognosis of patients.