慢性鼻窦炎患者术后嗅觉障碍的危险因素分析

Analysis of risk factors for postoperative olfactory disturbance in patients with chronic rhinosinusitis

目的 分析慢性鼻窦炎(CRS)患者术后嗅觉障碍的危险因素。方法 选取2020年3月~2022年3月我院耳鼻咽喉头颈外科收治的80例CRS患者,均行鼻内镜下鼻窦开放手术治疗。收集患者的临床相关资料,采用T&T标准嗅觉测试评估患者术后嗅觉恢复情况;采用单因素及多因素Logistic分析CRS患者术后嗅觉障碍的相关影响因素。结果 80例CRS患者中,术后3个月嗅觉正常着66例(82.50%),术后嗅觉障碍者有14例(17.50%);单因素分析结果显示,嗅觉障碍组的过敏、病变部位、吸烟史、嗜酸粒细胞百分比、Lund-Mackay评分与嗅觉正常组比较,差异具有统计学意义(P<0.05);经多因素Logistic分析结果显示,并发应变性鼻炎、嗅裂息肉、有吸烟史、嗜酸粒细胞百分比与Lund-Mackay评分是CRS患者术后嗅觉障碍的独立影响因素(P<0.05)。结论 并发应变性鼻炎、嗅裂息肉、有吸烟史、嗜酸粒细胞百分比与Lund-Mackay评分是CRS患者术后嗅觉障碍的独立影响因素;临床上可针对上述因素,对高危群体进行划分,制定护理及治疗方案,以改善与恢复患者术后嗅觉水平。

Objective To analyze the risk factors of postoperative olfactory disturbance in patients with chronic rhinosinusitis(CRS).Methods A total of 80 patients with CRS who were admitted to our hospital from March 2020 to March 2022 in the department of otolaryngology and head and neck Surgery were selected,and all of them underwent endoscopic sinus surgery.The clinical data of the patients were collected,and the T&T standard olfactory test was used to evaluate the postoperative olfactory recovery.Univariate and multivariate Logistic were used to analyze the related influencing factors of postoperative olfactory disturbance in CRS patients.Results Among the 80 CRS patients,66 cases(82.50%) had normal sense of smell at 3 months after operation,and 14 cases(17.50%) had abnormal sense of smell after operation.Univariate analysis showed that there were significant differences in allergy,lesion location,smoking history,eosinophil percentage,and Lund-Mackay score between the olfactory disorder group and the normal olfactory group(P<0.05).Multivariate Logistic analysis showed that concurrent strain rhinitis,olfactory cleft polyps,smoking history,eosinophil percentage and Lund-Mackay score were independent influencing factors of postoperative olfactory disturbance in CRS patients(P<0.05).Conclusion Complicated strain rhinitis,olfactory cleft polyps,smoking history,eosinophil percentage and Lund-Mackay score are independent influencing factors of postoperative olfactory disturbance in CRS patients.Clinically,the high-risk groups can be divided according to the above factors,and nursing and treatment programs can be formulated to improve and restore the postoperative olfactory level of patients.