鼻内窥镜手术治疗慢性鼻窦炎、鼻息肉的疗效观察

Treatment Outcome of 500 cases of Endoscopic Sinus Surgery

目的 :探讨鼻内窥镜手术治疗慢性鼻窦炎、鼻息肉的疗效及影响因素。方法 :5 0 0例慢性鼻窦炎、鼻息肉患者按临床分型分为 :Ⅰ型 16 5例 ,Ⅱ型 2 6 5例 ,Ⅲ型 110例。全部患者行鼻内窥镜手术治疗。对合并鼻中隔弯曲的 16 8例病人同时行鼻中隔矫正术。对合并下鼻甲极度肥大或息肉样变的 2 2 3例病人同时行下鼻甲成形术。术后用药包括抗生素、地塞米松、辅舒良气雾剂喷鼻。术后随访 1～ 19个月。结果 :Ⅰ型近期治愈率为 98.8% (16 2 / 16 5 ) ,Ⅱ型近期治愈率为 86 .2 % (194 / 2 2 5 ) ,Ⅲ型近期治愈率为 80 % (88/ 110 )。Ⅰ型与Ⅱ型、Ⅲ型近期治愈率比较 ,有显著性差异 (P <0 .0 1)。结论 :鼻内窥镜手术治疗慢性鼻窦炎、鼻息肉疗效显著 ,术中控制出血 ,正确处理中鼻甲及鼻中隔 ,及时解除粘连是提高治愈率的关键。

Objective:To study the treatment outcome of endoscopic sinus surgery and correlative factors following endoscopic sinus surgery.Methods:Five hundreds cases with chronic sinusitis and nasal polyp for the treatment in the hospital between march 2002 and October 2003 were reviewed.The number of patients with clinical stages from I to III were 165, 225, and 110, respectively.Four hundred thirty two patients were operated on under general anesthesia and 168 patients had septoplasty at same time.All patients were followed up for 1 to 19 months.Results:The clinical cure rates in short term from clinical stages I to III Were 98.8%,86.2%,and 80%,respectively.There were significant differences in the three groups(P<0.01).Conclusion:It is important to make a successful surgery preoperative evaluation, to improve surgical technique,to control bleeding during operation,to manage appropriately middle turbinate and nasal septum,and to have a postoperative follow-up in time and separation of synechiae timely.