修正性鼻内镜手术治疗慢性鼻—鼻窦炎鼻内镜术后复发的处理措施研究(1)
摘 要：目的 探讨修正性鼻内镜手术治疗慢性鼻-鼻窦炎鼻内镜术后复发的治疗措施。方法 回顾分析2015年6月～2018年6月在我院采用修正性鼻内镜手术治疗的120例慢性鼻-鼻窦炎鼻内镜术后复发患者临床资料，观察手术治疗疗效(手术前后临床症状评分、Lund-Kennedy鼻内镜检查评分、并发症发生情况)，探讨提高修正性鼻内镜手术效果的相关措施。结果 慢性鼻-鼻窦炎鼻内镜术后复发原因主要包括病变窦腔开放不全、解剖变异未矫正、术腔增生粘连、骨炎和变应性炎症；治疗总有效率为95.00%；术后临床症状(鼻塞、鼻涕、头痛、水肿)评分、Lund-Kennedy鼻内镜检查评分均低于术前，差异有统计学意义(P<0.05)；随访2个月，6例患者发生并发症，其中鼻中隔血肿3例，眶周皮下淤血1例，鼻泪管损伤1例，并发症发生率为5.00%。结论 慢性鼻-鼻窦炎鼻内镜术后复发较多，临床采用修正性鼻内镜手术式应做好术前充分准备，围术期应给予针对性护理，并熟练掌握鼻内镜手术操作技巧，以确保手术效果，提高临床治疗疗效。
关键词：慢性鼻-鼻窦炎；鼻内镜术；复发
, http://www.100md.com
中图分类号：R765.41 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.23.054
文章编号：1006-1959(2018)23-0183-03
Abstract：Objective To investigate the treatment of the recurrent chronic rhino-sinusitis after endoscopic surgery with modified endoscopic surgery.Methods The clinical data of 120 patients with recurrent chronic rhino-sinusitis after endoscopic surgery treated by modified endoscopic surgery.From June 2015 to June 2018 in our hospital were retrospectively analyzed.We observed the curative effect of surgical treatment (clinical symptom score， Lund-Kennedy nasal endoscopy score， complications before and after operation) in order to explore the related measures to improve the effect of modified endoscopic sinus surgery.Results The main causes of ecurrent chronic rhino-sinusitis after endoscopic surgery included inoperable sinus cavity， uncorrected anatomic variation， hyperplastic adhesion， osteositis and allergic inflammation. The total effective rate was 95.00%.The scores of clinical symptoms (nasal obstruction， nasal snot， headache， edema) and Lund-Kennedy nasal endoscopy were significantly lower than those before operation (P<0.05).With a follow up for 2 months，complications occurred in 6 cases，including nasal septum hematoma in 3 cases， periorbital subcutaneous congestion in 1 case and nasolacrimal duct injury in 1 case.The incidence of complications was 5.00%.ConclusionThe recurrence of chronic rhino-sinusitis after endoscopic surgery is more frequent.The clinical application of modified endoscopic sinus surgery should be well prepared before operation， the perioperative period should be given targeted nursing care， and the operation skills of nasal endoscopic surgery should be mastered skillfully in order to ensure the operation effect， improve the clinical treatment effect.
, 百拇医药
Key words：Chronic rhino-sinusitis；Endoscopic surgery；Recurrence
慢性鼻-鼻窦炎(chronic rhino-sinusitis，CRS)是临床常见的多发病，病情迁延不愈，容易反复发作，严重影响患者的健康[1]。目前鼻内镜微创手术是治疗慢性鼻-鼻窦炎的有效手段，但是仍有约20%左右的患者术后病情不能获得持久缓解。鼻竇炎复发的病因较为复杂，而复发性慢性鼻-鼻窦炎临床治疗难度更是较大。因此，临床分析复发性慢性鼻-鼻窦炎原因，并给予针对性的措施，提高修正性鼻内镜手术效果具有重要的临床价值。本文作者结合2015年6月～2018年6月在我院采用修正性鼻内镜手术治疗的120例慢性鼻-鼻窦炎鼻内镜术后复发患者临床资料，分析复发的原因并总结提高修正性鼻内镜手术效果相关措施，为临床提供一定的参考依据，现报告如下。, http://www.100md.com(罗文广 童敏 张克春)
关键词：慢性鼻-鼻窦炎；鼻内镜术；复发
, http://www.100md.com
中图分类号：R765.41 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.23.054
文章编号：1006-1959(2018)23-0183-03
Abstract：Objective To investigate the treatment of the recurrent chronic rhino-sinusitis after endoscopic surgery with modified endoscopic surgery.Methods The clinical data of 120 patients with recurrent chronic rhino-sinusitis after endoscopic surgery treated by modified endoscopic surgery.From June 2015 to June 2018 in our hospital were retrospectively analyzed.We observed the curative effect of surgical treatment (clinical symptom score， Lund-Kennedy nasal endoscopy score， complications before and after operation) in order to explore the related measures to improve the effect of modified endoscopic sinus surgery.Results The main causes of ecurrent chronic rhino-sinusitis after endoscopic surgery included inoperable sinus cavity， uncorrected anatomic variation， hyperplastic adhesion， osteositis and allergic inflammation. The total effective rate was 95.00%.The scores of clinical symptoms (nasal obstruction， nasal snot， headache， edema) and Lund-Kennedy nasal endoscopy were significantly lower than those before operation (P<0.05).With a follow up for 2 months，complications occurred in 6 cases，including nasal septum hematoma in 3 cases， periorbital subcutaneous congestion in 1 case and nasolacrimal duct injury in 1 case.The incidence of complications was 5.00%.ConclusionThe recurrence of chronic rhino-sinusitis after endoscopic surgery is more frequent.The clinical application of modified endoscopic sinus surgery should be well prepared before operation， the perioperative period should be given targeted nursing care， and the operation skills of nasal endoscopic surgery should be mastered skillfully in order to ensure the operation effect， improve the clinical treatment effect.
, 百拇医药
Key words：Chronic rhino-sinusitis；Endoscopic surgery；Recurrence
慢性鼻-鼻窦炎(chronic rhino-sinusitis，CRS)是临床常见的多发病，病情迁延不愈，容易反复发作，严重影响患者的健康[1]。目前鼻内镜微创手术是治疗慢性鼻-鼻窦炎的有效手段，但是仍有约20%左右的患者术后病情不能获得持久缓解。鼻竇炎复发的病因较为复杂，而复发性慢性鼻-鼻窦炎临床治疗难度更是较大。因此，临床分析复发性慢性鼻-鼻窦炎原因，并给予针对性的措施，提高修正性鼻内镜手术效果具有重要的临床价值。本文作者结合2015年6月～2018年6月在我院采用修正性鼻内镜手术治疗的120例慢性鼻-鼻窦炎鼻内镜术后复发患者临床资料，分析复发的原因并总结提高修正性鼻内镜手术效果相关措施，为临床提供一定的参考依据，现报告如下。, http://www.100md.com(罗文广 童敏 张克春)