真菌性鼻窦炎患者经鼻内镜手术治疗的疗效及术后复发的影响因素分析

Analysis of the efficacy of endonasal endoscopic surgical treatment for fungal rhinosinusitis patients and the factors affecting postoperative recurrence

目的 探讨真菌性鼻窦炎患者经鼻内镜手术治疗的疗效及术后复发的影响因素分析.方法 按回顾性分析纳入2020年1月-2023年1月南京鼓楼医院收治的80例真菌性鼻窦炎患者作为研究对象,均接受经鼻内镜手术,观察其疗效,并根据患者术后是否复发分为复发组和未复发组.对比两组临床资料和疾病相关特征,选择Logistic回归分析有差异项目,得出影响患者术后复发的因素.结果 该研究纳入80例真菌性鼻窦炎患者,所有患者均接受鼻内镜手术治疗,术后临床疗效显效率为27.50%(22例),有效率37.50%(30例),无效率35.00%(28例).入组患者均在术后完成为期6个月的有效随访,观察患者是否复发,根据术后是否复发分成复发组与未复发组,其中复发组共25例,占比31.25%,未复发组患者共55例,占比68.75%;复发组在病变程度、支气管哮喘、术后感染、Lund-Mackay评分方面和未复发组存在显著差异(P<0.05);经Logistic回归方程分析,发现上述指标均是患者术后复发的影响因素,AUC值范围为0.702-0.725之间,其灵敏度和特异度较高,预测患者术后复发的价值较高.结论 真菌性鼻窦炎患者经鼻内镜手术治疗后术后复发的影响因素较多,临床需引起重视,尽早制定对应措施进行干预.

Objective To explore the efficacy of transnasal endoscopic surgical treatment in patients with fungal sinusitis and the analysis of factors affecting postoperative recurrence.Methods 80 cases of fungal sinusitis patients admitted to our hospital from January 2020 to January 2023 were included as research subjects by retrospective analysis,all of them received transnasal endoscopic surgery to observe their efficacy,and they were divided into recurrence and non-recurrence groups according to whether the patients had recurrence afer surgery.Comparing the clinical data and disease-related characteristics of the two groups,we chose Logistic regression to analyse the dfferent items,and came up with the factors affecting the patients'postoperative recurrence.Results Eighty patients with fungal sinusitis were included in this study,and all of them were treated with nasal endoscopic surgery,and the postoperative clinical efficacy was 27.50%(22 cases),the effective rate was 37.50%(30 cases),and the inefficiency was 35.00%(28 cases).The enrolled patients all completed a 6-month effective postoperative follow-up to observe whether the patients had recurrence or not,and were divided into recurrence group and non-recurrence group according to whether they had recurrence or not after surgery,among which there were a total of 25 cases in the recurrence group.which accounted for 31.25%,and a total of 55 patients in the non-recurrence group,which accounted for 68.75%;there was a significant diference in the degree of lesion,bronchial asthma,postoperative infection,Lund-Mackay score and the non-recurrence group in the recurrence group(P<0.05);analyzed by Logistic regression equation,it was found that all of the above indexes were the influencing factors of patients'postoperative recurrence,and the AUC value ranged between 0.702-0.725,with high sensitivity and specificity,and the value of predicting patients'postoperative recurrence was high.Conclusion Fungal sinusitis patients treated by nasal endoscopic surgery has more factors affecting postoperative recurrence,clinical atention should be paid to the early development of corresponding measures for intervention.