不同鼻内镜术式对难治性鼻窦炎疗效及安全性的影响(1)
[摘要] 目的 探讨不同鼻内镜术式在难治性鼻窦炎临床治疗中的应用疗效，比较其安全性，结合患者接受鼻内镜术后的恢复情况进行评价。方法 方便选取2017年11月—2018年8月期间于该院接受鼻内镜手术的102例患者作为研究对象，分为观察组(轮廓化鼻内镜手术)和对照组(功能性鼻内窥镜手术)，各51例。观察两组患者的手术治疗及其术后恢复情况。结果 与治疗前相比，治疗后两组患者的疼痛症状和鼻腔及鼻窦黏膜功能得到显著恢复，主要表现为疼痛VAS评分、Lund-Kennedy评分以及Lund-Mackay评分的降低(P<0.05)。与对照组相比，观察组患者的治愈率(90.20%>72.55%，χ2=5.239)相对更高(P<0.05)，而复发率(11.76%<27.45%，χ2=3.980)、疼痛VAS评分[(1.26±0.41)分<(3.49±0.71)分，t=5.194]、Lund-Kennedy评分[(4.72±0.61)分<(5.94±0.75)分，t=5.381]以及Lund-Mackay评分[(4.95±0.92)分<(11.24±1.16)分，t=4.152]相对更低(P<0.05)，两组患者术后你并发症发生率对照相仿(P>0.05)。结论 鼻内镜手术是治疗难治性鼻窦炎的有效方法，其中轮廓化鼻内镜手术是更为安全、有效的术式，具有很高的临床应用价值。
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[关键词] 鼻内镜术式;难治性鼻窦炎;疗效;安全性
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2019)12(a)-0030-03
[Abstract] Objective To investigate the clinical efficacy of different endoscopic sinus surgery in the treatment of refractory sinusitis， compare its safety， and evaluate the recovery of patients after endoscopic sinus surgery. Methods 102 patients who underwent endoscopic sinus surgery in the hospital from November 2017 to August 2018 were convenient selected and divided into observation group (contoured endoscopic sinus surgery) and control group (functional endoscopic sinus surgery). Surgical treatment and postoperative recovery were observed in both groups. Results Compared with before treatment， the pain symptoms and nasal and sinus mucosal function of the two groups were significantly restored after treatment， mainly including pain VAS score， Lund-Kennedy score and Lund-Mackay score reduction (P<0.05). Compared with the control group， the cure rate of the observation group (90.20%>72.55%， χ2=5.239) was relatively higher (P<0.05)， while the recurrence rate (11.76%<27.45%， χ2=3.980)， pain VAS score [(1.26 ± 0.41) points < (3.49 ± 0.71) points， t=5.194]， Lund-Kennedy score [(4.72 ± 0.61) points < (5.94 ± 0.75) points， t=5.381] and Lund-Mackay score [( 4.95±0.92) points < (11.24±1.16) points， t=4.152] were relatively lower (P<0.05)， and the incidence of postoperative complications in the two groups was photographic (P>0.05). Conclusion Endoscopic sinus surgery is an effective method for the treatment of refractory sinusitis， and contoured endoscopic sinus surgery is a safer and more effective method with high clinical application value.
, http://www.100md.com
[Key words] Endoscopic sinus surgery; Refractory sinusitis; Efficacy; Safety
難治性鼻窦炎患者的鼻腔、鼻窦组织受到病菌感染，形成炎症症状，引发鼻塞、流涕、嗅觉下降等症状，影响其鼻腔正常通气。患者受到鼻窦炎的影响，会出现鼻腔血管扩张、头部静脉压增高等情况，进而导致头痛症状的加剧。经过抗感染治疗后，病情仍然出现反复发作的情况，长期、持续困扰患者的日常生活[1]。为了更加彻底的治愈疾病，需要采取手术方法进行治疗，直接作用于病灶，清除病变组织，进而改善患者的鼻窦功能。在难治性鼻窦炎的手术治疗中，一般采用鼻内镜手术方法，利用鼻内镜，清晰的观察鼻腔、鼻窦组织，便于实施精细化的手术操作，在清除病灶组织的同时，尽可能减轻手术操作对于鼻腔、鼻窦的损害，充分保障手术治疗的安全性。在鼻内镜术式的选择上，可选用轮廓化鼻内镜手术或功能性鼻内窥镜手术方法[2]。该研究方便选取2017年11月—2018年8月期间于该院接受鼻内镜手术的102例难治性鼻窦炎患者作为研究对象，比较不同鼻内镜术式的应用疗效及安全性，现报道如下。, http://www.100md.com(林金成)
, http://www.100md.com
[关键词] 鼻内镜术式;难治性鼻窦炎;疗效;安全性
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2019)12(a)-0030-03
[Abstract] Objective To investigate the clinical efficacy of different endoscopic sinus surgery in the treatment of refractory sinusitis， compare its safety， and evaluate the recovery of patients after endoscopic sinus surgery. Methods 102 patients who underwent endoscopic sinus surgery in the hospital from November 2017 to August 2018 were convenient selected and divided into observation group (contoured endoscopic sinus surgery) and control group (functional endoscopic sinus surgery). Surgical treatment and postoperative recovery were observed in both groups. Results Compared with before treatment， the pain symptoms and nasal and sinus mucosal function of the two groups were significantly restored after treatment， mainly including pain VAS score， Lund-Kennedy score and Lund-Mackay score reduction (P<0.05). Compared with the control group， the cure rate of the observation group (90.20%>72.55%， χ2=5.239) was relatively higher (P<0.05)， while the recurrence rate (11.76%<27.45%， χ2=3.980)， pain VAS score [(1.26 ± 0.41) points < (3.49 ± 0.71) points， t=5.194]， Lund-Kennedy score [(4.72 ± 0.61) points < (5.94 ± 0.75) points， t=5.381] and Lund-Mackay score [( 4.95±0.92) points < (11.24±1.16) points， t=4.152] were relatively lower (P<0.05)， and the incidence of postoperative complications in the two groups was photographic (P>0.05). Conclusion Endoscopic sinus surgery is an effective method for the treatment of refractory sinusitis， and contoured endoscopic sinus surgery is a safer and more effective method with high clinical application value.
, http://www.100md.com
[Key words] Endoscopic sinus surgery; Refractory sinusitis; Efficacy; Safety
難治性鼻窦炎患者的鼻腔、鼻窦组织受到病菌感染，形成炎症症状，引发鼻塞、流涕、嗅觉下降等症状，影响其鼻腔正常通气。患者受到鼻窦炎的影响，会出现鼻腔血管扩张、头部静脉压增高等情况，进而导致头痛症状的加剧。经过抗感染治疗后，病情仍然出现反复发作的情况，长期、持续困扰患者的日常生活[1]。为了更加彻底的治愈疾病，需要采取手术方法进行治疗，直接作用于病灶，清除病变组织，进而改善患者的鼻窦功能。在难治性鼻窦炎的手术治疗中，一般采用鼻内镜手术方法，利用鼻内镜，清晰的观察鼻腔、鼻窦组织，便于实施精细化的手术操作，在清除病灶组织的同时，尽可能减轻手术操作对于鼻腔、鼻窦的损害，充分保障手术治疗的安全性。在鼻内镜术式的选择上，可选用轮廓化鼻内镜手术或功能性鼻内窥镜手术方法[2]。该研究方便选取2017年11月—2018年8月期间于该院接受鼻内镜手术的102例难治性鼻窦炎患者作为研究对象，比较不同鼻内镜术式的应用疗效及安全性，现报道如下。, http://www.100md.com(林金成)