功能性内镜鼻窦手术与根治性内镜鼻窦手术治疗嗜酸粒细胞增高型慢性鼻窦炎伴鼻息肉的对比研究

Comparative Study of Functional Endoscopic Sinus Surgery and Radical Endoscopic Sinus Surgery for the Treatment of Eosinophilic Chronic Rhinosinusitis with Nasal Polyps

目的 探讨嗜酸粒细胞增高型慢性鼻窦炎伴鼻息肉(Eosinophilic Chronic Rhinosinusitis with Nasal Polyps,EosCRSwNP)患者应用根治性内镜鼻窦手术(Radical Endoscopic Sinus Surgery,RESS)与功能性内镜鼻窦手术(Functional Endoscopic Sinus Surgery,FESS)进行治疗的临床价值。方法 回顾性选取2018年1月—2023年11月青岛市黄岛区中医医院收治的280例EosCRSwNP患者的临床资料,根据所选术式,将其分为A组与B组,各140例。A组行FESS治疗,B组行RESS治疗,比较两组病情控制情况、鼻内镜与鼻窦CT量化评分、汉化版鼻腔鼻窦结果测量22条量表(Sino-nasal Outcome Test-22,SNOT-22)评分、术后并发症及复发情况。结果B组病情控制率为96.43%,高于A组的88.57%,差异有统计学意义(χ^(2)=6.229,P=0.013)。B组鼻内镜与鼻窦CT量化评分、SNOT-22评分、不良事件发生率均低于A组,差异有统计学意义(P均<0.05)。结论 与FESS治疗比较,对EosCRSwNP患者采用RESS治疗能够提升患者的病情控制效果及其生活质量,并降低不良事件发生率。

Objective To explore the clinical value of the application of radical endoscopic sinus surgery(RESS) and functional endoscopic sinus surgery(FESS) for the treatment of patients with eosinophilic chronic rhinosinusitis with nasal polyps(EosCRSwNP).Methods The clinical data of 280 patients with EosCRSwNP admitted to Qingdao Huangdao District Hospital of Traditional Chinese Medicine from January 2018 to November 2023 were retrospectively selected,and they were divided into group A and group B,each with 140 cases,according to the selected operation.Group A was treated with FESS and group B was treated with RESS.The two groups were compared in terms of disease control,quantitative scores of nasal endoscopy and sinus CT,scores of the Sino-nasal Outcome Test-22(SNOT-22),postoperative complications and recurrence.Results The disease control rate in group B was 96.43%,which was higher than 88.57% in group A,and the difference was statistically significant(χ^(2)=6.229,P=0.013).The incidence of adverse events such as quantitative nasal endoscopy and sinus CT scores,SNOT-22 scores were lower in group B than those in group A,and the difference was statistically significant(all P<0.05).Conclusion Compared with FESS treatment,the use of RESS treatment for EosCRSwNP patients can improve the patient's disease control effect and their quality of life,and reduce the incidence of adverse events.