慢性鼻-鼻窦炎经功能性内镜鼻窦手术治疗预后的影响因素分析

Influencing factors of prognosis on chronic rhinosinusitis after functional endoscopic sinus surgery

目的本研究旨在探讨慢性鼻-鼻窦炎(CRS)经功能性内镜鼻窦手术治疗后复发的影响因素。方法回顾性分析2018-2021年海军军医大学海军特色医学中心耳鼻咽喉头颈外科收治的经鼻内镜治疗179例CRS患者的临床资料,通过单因素分析,Logistic回归模型行多因素分析,确定CRS经功能性内镜鼻窦手术治疗预后的独立影响因素。结果179例CRS患者接受功能性内镜鼻窦手术治疗后,1年内复发35例(19.6%)。单因素分析结果显示:伴变应性鼻炎、伴鼻中隔偏曲、伴鼻息肉、鼻窦CT Lund-Mackay评分总分、鼻内镜Lund-Kennedy评分总分、外周血嗜酸性粒细胞百分比、术后未进行换药、术后未规律药物治疗与CRS经功能性内镜鼻窦手术治疗后1年内复发相关。Logistic回归分析结果提示其中鼻窦CT Lund-Mackay评分总分、外周血嗜酸性粒细胞百分比、术后未规律药物治疗是影响CRS经功能性内镜鼻窦手术治疗预后的独立危险因素。结论鼻窦CT Lund-Mackay评分总分、外周血嗜酸性粒细胞百分比、术后未规律药物治疗是影响CRS经功能性内镜鼻窦手术治疗预后的独立危险因素。

Objective To explore the influencing factors of recurrence in chronic rhinosinusitis(CRS)after functional endoscopic sinus surgery(FESS).Methods A retrospective analysis was conducted on the clinical data of 179 patients with CRS undergoing FESS in our department from 2018 to 2021.Univariate analysis and logistic regression model were used to conduct multivariate analysis to determine the independent influencing factors for the prognosis of CRS after FESS.Results Among the 179 CRS patients,35 cases(19.6%)experienced recurrence within one year after FESS.Univariate analysis showed that comorbidities of allergic rhinitis,nasal septal deviation,nasal polyps,total Lund-Mackay score of sinuse computed tomography(CT),total Lund-Kennedy score of nasal endoscopy,percentage of eosinophils in peripheral blood,no dressing change after surgery,and irregular medication treatment after FESS were related with the recurrence of CRS.Logistic regression analysis indicated that the total Lund-Mackay score of sinus CT,the percentage of eosinophils in peripheral blood,and irregular postoperative drug therapy were independent risk factors affecting the prognosis of CRS after FESS.Conclusion The total Lund-Mackay score of sinus CT,percentage of eosinophils in peripheral blood,and irregular postoperative drug therapy are independent risk factors affecting the prognosis of CRS after FESS.