慢性鼻窦炎鼻息肉内镜术后综合治疗

Study of systematic therapy after nasal endoscopic surgery for nasal polyp and chronic sinusitis patients

目的探讨慢性鼻窦炎鼻息肉经鼻内镜手术后影响疗效的因素及其预防措施。方法对因慢性鼻窦炎鼻息肉接受鼻内镜手术,随访3年以上的346例患者,从职业、气候、体质性原因、术后是否坚持系统的综合治疗及持续时间、临床转归等方面进行回顾性分析。结果从事接触刺激性物或粉尘的职业、因气候变化易上呼吸道感染者、术后(尤其是出院后)根本不曾或不能坚持进行系统综合治疗(包括局部用药、全身用药、鼻腔冲洗、定期鼻内镜下清理术腔等)的患者与具有前述“特质”的患者鼻窦炎、鼻息肉复发的可能性明显居高,复发时间亦明显提前;具备前述“特质”类别愈多,复发愈快、愈剧。其中尤以系统综合治疗对术后转归影响最显著。结论术后定期、足够疗程的系统综合治疗是提高慢性鼻窦炎鼻息肉经鼻内镜手术疗效的有力措施,良好的职业保护和增强自身体质能有效地预防和减缓慢性鼻窦炎鼻息肉经鼻内镜术后的复发。

Objective To introduce the possible factors affecting the results of nasal endoscpic surgery in chronic sinusitis and nasal polyp patients and to dicuss the way to improve the results of operation. Methods Retrospective analysis was done in 346 patients followed up more then 3 year. The analysis was focused on patients occupation, climate, personal constitutional, extent of persisting on systematic therapy after operation and clinical recovery status. Results The patients who work in the environment rich of irri- tating substance and dust, the patients easy affecting upper respiratory tract infection and the patients who did not take or insist on systematic therapy after operation (e. g: local and systemic medication, nasal lavage and deaning up of surgical cavities under nasal endo-scope) had higher frequency of relapse and quicker recurrence. Systematic therapy was the most important factor affecting the results of operation. Conclusion Insisting on systemic rehabilitation therapy after operation is a powerful way to improve the results of nasal en-doscopic surgery in chronic sinusitis and nasal polyp patients. Good occupation protection and building up personal constitution can prevent and reduce the recurrence of chronic sinusitis and nasal polyp after nasal endoscopic surgery.