鼻内窥镜手术应用于慢性鼻-鼻窦炎治疗的效果研究
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摘要
目的探讨改良鼻内窥镜手术治疗慢性鼻-鼻窦炎的临床效果。方法选取2016年1月～2017年12月期间我院收治的80例慢性鼻-鼻窦炎患者,依据治疗方式不同将其分为对照组(传统鼻内窥镜手术)和观察组(改良鼻内窥镜手术),每组各40例,比较两组治疗的临床疗效,术前及术后症状评分变化,以及手术治疗对两组患者嗅觉功能的影响。结果观察组治疗总有效率(97.5%)显著高于对照组(85.0%),差异有统计学意义(P<0.05);观察组术后鼻塞、鼻分泌物、头晕头痛、嗅觉障碍等主要症状评分均显著低于对照组,差异有统计学意义(P <0.05);观察组术后3个月和6个月患者嗅觉功能CCCRC评分均显著高于对照组,差异有统计学意义(P <0.05)。结论鼻内窥镜手术应用于慢性鼻-鼻窦炎治疗中,能够明显提高手术治疗的临床效果,显著改善患者的临床症状及嗅觉功能。
Objective To explore the clinical effect of modified nasal endoscopic surgery in the treatment of chronic rhinosinusitis. Methods From January 2016 to December 2017,80 patients with chronic rhinosinusitis were divided into control group(endoscopic sinus surgery)and observation group(functional endoscopic sinus surgery)according to different treatment methods. Each group had 40 cases. The clinical efficacy,preoperative and postoperative symptoms score changes,and surgery were compared between the two groups. Effect of treatment on olfactory function of two groups. Results The total effective rate of the observation group(97.5%)was significantly higher than that of the control group(85.0%)and the difference was statistically significant(P<0.05);the scores of the main symptoms such as nasal obstruction,nasal secretion,dizziness, headache and olfactory disturbance in the observation group were significantly lower than those in the control group(P<0.05). CCCRC scores of olfactory function in 6 months were significantly higher than those in control group(P<0.05). Conclusion Endoscopic sinus surgery in the treatment of chronic rhinosinusitis,can significantly improve the clinical effect of surgical treatment,significantly improve the clinical symptoms and olfactory function of patients.
Objective To explore the clinical effect of modified nasal endoscopic surgery in the treatment of chronic rhinosinusitis. Methods From January 2016 to December 2017,80 patients with chronic rhinosinusitis were divided into control group(endoscopic sinus surgery)and observation group(functional endoscopic sinus surgery)according to different treatment methods. Each group had 40 cases. The clinical efficacy,preoperative and postoperative symptoms score changes,and surgery were compared between the two groups. Effect of treatment on olfactory function of two groups. Results The total effective rate of the observation group(97.5%)was significantly higher than that of the control group(85.0%)and the difference was statistically significant(P<0.05);the scores of the main symptoms such as nasal obstruction,nasal secretion,dizziness, headache and olfactory disturbance in the observation group were significantly lower than those in the control group(P<0.05). CCCRC scores of olfactory function in 6 months were significantly higher than those in control group(P<0.05). Conclusion Endoscopic sinus surgery in the treatment of chronic rhinosinusitis,can significantly improve the clinical effect of surgical treatment,significantly improve the clinical symptoms and olfactory function of patients.
引文
1.王德辉,许庚.病情评估对慢性鼻-鼻窦炎治疗决策的影响内镜手术疗效影响因素分析.中华耳鼻咽喉头颈外科杂志,2013,48:111-113.
2.陈禹潭,曹金红,李艳妮,等.慢性鼻-鼻窦炎内镜手术疗效影响因素分析.中华耳鼻咽喉头颈外科杂志,2013,48:511-513.
3.彭本刚,孙轶青,苗旭涛,等.复发性鼻窦炎规范性综合治疗体会.临床耳鼻咽喉头颈外科杂志,2014,28:813-816.
4.汪志坚,龚志龙.鼻内窥镜手术加下鼻道开窗术治疗非侵袭性真菌性鼻窦炎的临床效果分析.中国现代医生,2016,54(14):63-65.
5.段怀庆.鼻内窥镜治疗慢性鼻窦炎鼻息肉临床效果观察.基层医学论坛,2012,16:3455-3456.
6.曹雪秋.鼻内镜治疗老年慢性鼻窦炎鼻息肉122例.中国老年学杂志,2013,33:1399-1400.
7.朱冬超.鼻内窥镜手术治疗慢性鼻-鼻窦炎疗效及影响因素分析.中外医疗,2017,4(12):62-64.
8.蒋敏.鼻内镜治疗鼻窦炎合并鼻息肉的疗效及其对患者嗅觉的影响.中国现代医生,2015,53(3):87-89.
9.邓伟光.鼻息肉鼻窦炎鼻内窥镜手术治疗疗效分析.当代医学,2013,19(7):87-88.
10.徐艳红,何刚,黄定强,等.慢性鼻-鼻窦炎鼻内镜手术预后的影响因素分析.实用医院临床杂志,2013,10:117-118.
11.Hall AG,deShazo RD.Immunotherapy for allergic fungal sinusitis.Curr Opin Allergy Clin Immunol,2012,12:629-634.
12.Pao KY,Yakopson V,Flanagan JC,et al.Allergic fungal sinusitis involving the Iacrimal sac:A case report and review.Orbit,2014,33:311-313.
13.李纪辉,朱汉平,磨宾宇,等.鼻内窥镜下手术治疗慢性鼻窦炎鼻息肉的疗效分析.海南医学,2013,24:1512-1514.
14.焦雪芹,张利平.鼻内镜下治疗鼻窦炎合并鼻息肉的临床疗效研究.中国现代医生,2014,52:133-135.
15.Venetis G,Bourlidou E,Liokatis PG,et al.Endoscopic assistance in the diagnosis and treatment of odontogenic maxillary sinus disease.Oral Maxillofac Surg,2014,18:207-212.
16.Feng S,Liang Z,Zhang R,et al.Effects of mobile phone WeChat services improve adherence to corticosteroid nasal spray treatment for chronic rhinosinusitis after functional endoscopic sinus surgery:a3-month follow-up study.Eur Arch Otorhinolaryngol,2017,274:1477-1485.
17.Lourijsen ES,de Borgie CA,Vleming M,et al.Endoscopic sinus surgery in adult patients with chronic rhinosinusitis with nasal polyps(PolyESS):study protocol for a randomized controlled trial.Trials,2017,18:39.
18.Veloso-Teles R,Cerejeira R.Endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps:clinical outcome and predictive factors of recurrence.Am J Rhinol Allergy,2017,31:56-62.
19.Askar MH,Gamea A,Tomoum MO,et al.Endoscopic management of chronic frontal sinusitis:prospective quality of life analysis.Ann Otol Rhinol Laryngol,2015,124:638-648.
20.Al Kadah B,Bozzato V,Bozzato A,et al.A novel multipurpose mini-endoscope for frontal sinus endoscopy“sinus view”.Eur Arch Otorhinolaryngol,2015,272:1693-1698.
21.Low TH,Woods CM,Ullah S,et al.A double-blind randomized controlled trial of normal saline lactated ringer’s and hypertonic saline nasal irrigation solution after endoscopic sinus surgery.Am J Rhinol Allergy,2014,28:225-231.
22.Varvyanskaya A,Lopatin A.Efficacy of long-term low-dose macrolide therapy in preventing early recurrence of nasal polyps after endoscopic sinus surgery.Int Forum Allergy Rhinol,2014,4:533-541.
23.曹辉.鼻息肉鼻窦炎鼻内窥镜手术治疗疗效分析.河北医药,2012,34:2447-2448.
24.Thompson CF,Kern RC,Conley DB.Olfaction in endoscopic sinus and skull base surgery.Otolaryngol Clin North Am,2015,48:795-804.
25.Dautremont JF,Rudmik L.When are we operating for chronic rhinosinusitis.A systematic review of maximal medical therapy protocols prior to endoscopic sinus surgery.Int Forum Allergy Rhinol,2015,5:1095-1103.
2.陈禹潭,曹金红,李艳妮,等.慢性鼻-鼻窦炎内镜手术疗效影响因素分析.中华耳鼻咽喉头颈外科杂志,2013,48:511-513.
3.彭本刚,孙轶青,苗旭涛,等.复发性鼻窦炎规范性综合治疗体会.临床耳鼻咽喉头颈外科杂志,2014,28:813-816.
4.汪志坚,龚志龙.鼻内窥镜手术加下鼻道开窗术治疗非侵袭性真菌性鼻窦炎的临床效果分析.中国现代医生,2016,54(14):63-65.
5.段怀庆.鼻内窥镜治疗慢性鼻窦炎鼻息肉临床效果观察.基层医学论坛,2012,16:3455-3456.
6.曹雪秋.鼻内镜治疗老年慢性鼻窦炎鼻息肉122例.中国老年学杂志,2013,33:1399-1400.
7.朱冬超.鼻内窥镜手术治疗慢性鼻-鼻窦炎疗效及影响因素分析.中外医疗,2017,4(12):62-64.
8.蒋敏.鼻内镜治疗鼻窦炎合并鼻息肉的疗效及其对患者嗅觉的影响.中国现代医生,2015,53(3):87-89.
9.邓伟光.鼻息肉鼻窦炎鼻内窥镜手术治疗疗效分析.当代医学,2013,19(7):87-88.
10.徐艳红,何刚,黄定强,等.慢性鼻-鼻窦炎鼻内镜手术预后的影响因素分析.实用医院临床杂志,2013,10:117-118.
11.Hall AG,deShazo RD.Immunotherapy for allergic fungal sinusitis.Curr Opin Allergy Clin Immunol,2012,12:629-634.
12.Pao KY,Yakopson V,Flanagan JC,et al.Allergic fungal sinusitis involving the Iacrimal sac:A case report and review.Orbit,2014,33:311-313.
13.李纪辉,朱汉平,磨宾宇,等.鼻内窥镜下手术治疗慢性鼻窦炎鼻息肉的疗效分析.海南医学,2013,24:1512-1514.
14.焦雪芹,张利平.鼻内镜下治疗鼻窦炎合并鼻息肉的临床疗效研究.中国现代医生,2014,52:133-135.
15.Venetis G,Bourlidou E,Liokatis PG,et al.Endoscopic assistance in the diagnosis and treatment of odontogenic maxillary sinus disease.Oral Maxillofac Surg,2014,18:207-212.
16.Feng S,Liang Z,Zhang R,et al.Effects of mobile phone WeChat services improve adherence to corticosteroid nasal spray treatment for chronic rhinosinusitis after functional endoscopic sinus surgery:a3-month follow-up study.Eur Arch Otorhinolaryngol,2017,274:1477-1485.
17.Lourijsen ES,de Borgie CA,Vleming M,et al.Endoscopic sinus surgery in adult patients with chronic rhinosinusitis with nasal polyps(PolyESS):study protocol for a randomized controlled trial.Trials,2017,18:39.
18.Veloso-Teles R,Cerejeira R.Endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps:clinical outcome and predictive factors of recurrence.Am J Rhinol Allergy,2017,31:56-62.
19.Askar MH,Gamea A,Tomoum MO,et al.Endoscopic management of chronic frontal sinusitis:prospective quality of life analysis.Ann Otol Rhinol Laryngol,2015,124:638-648.
20.Al Kadah B,Bozzato V,Bozzato A,et al.A novel multipurpose mini-endoscope for frontal sinus endoscopy“sinus view”.Eur Arch Otorhinolaryngol,2015,272:1693-1698.
21.Low TH,Woods CM,Ullah S,et al.A double-blind randomized controlled trial of normal saline lactated ringer’s and hypertonic saline nasal irrigation solution after endoscopic sinus surgery.Am J Rhinol Allergy,2014,28:225-231.
22.Varvyanskaya A,Lopatin A.Efficacy of long-term low-dose macrolide therapy in preventing early recurrence of nasal polyps after endoscopic sinus surgery.Int Forum Allergy Rhinol,2014,4:533-541.
23.曹辉.鼻息肉鼻窦炎鼻内窥镜手术治疗疗效分析.河北医药,2012,34:2447-2448.
24.Thompson CF,Kern RC,Conley DB.Olfaction in endoscopic sinus and skull base surgery.Otolaryngol Clin North Am,2015,48:795-804.
25.Dautremont JF,Rudmik L.When are we operating for chronic rhinosinusitis.A systematic review of maximal medical therapy protocols prior to endoscopic sinus surgery.Int Forum Allergy Rhinol,2015,5:1095-1103.