喻继康

(邛崃市医疗中心医院耳鼻咽喉科，四川　邛崃 611500)



不同术式对慢性鼻窦炎或鼻息肉患者的近期疗效及预后研究

喻继康

(邛崃市医疗中心医院耳鼻咽喉科，四川邛崃 611500)

目的：探讨慢性鼻窦炎或鼻息肉患者采用鼻内镜手术的临床治疗效果及相关影响因素。方法：选取2013年8月至2014年9月期间接受治疗的慢性鼻窦炎或鼻息肉患者89例。其中42例行鼻内镜手术的患者作为观察组，47例行常规鼻腔、鼻窦手术的患者作为对照组，比较两组患者手术治疗的效果及术后随访1年出现并发症或复发的情况，并分析观察组临床治疗效果的相关影响因素。结果：观察组患者治疗的总有效率(92.86%)显著高于对照组患者治疗的总有效率(76.59%)，差异具有统计学意义(P<0.05)；两组研究对象患者术后1年随访发现，对照组患者出现复发或并发症的发生率显著高于观察组患者，差异具有统计学意义(P=0.034)；运用Logistic多因素逐步回归分析方法分析发现工作环境、合并症及术后综合治疗是影响鼻内镜手术临床治疗效果的相关危险因素。结论：经鼻内镜手术治疗慢性鼻窦炎、鼻息肉疗效要显著好于常规鼻腔、鼻窦手术，且术后复发率低及并发症少，可操作性高，值得在临床治疗上推广。

鼻内镜手术；慢性鼻窦炎；鼻息肉；相关影响因素

【Abstract】Objective：To explore clinical effects and relevant influencing factors of nasal endoscopic surgery for the patients with chronic sinusitis or nasal polyps.Methods：89 cases of chronic sinusitis and nasal polyps treated in our hospital from August 2013 to September 2014 were selected.42 patients with nasal endoscopic surgery were classified as the observation group,47 patients with routine nasal and sinus surgery were classified as the control group,the effect of surgical treatment and complications or recurrence of patients followed up for one year were compared between the two groups,and the clinical treatment effect and relevant influencing factors of observation group were analyzed.Results：The total effective rate (92.86%)of treatment in observation group was significantly higher than that in control group,and the difference is statistically significant (P< 0.05);it found that after one year follow-up of two groups of subjects,the recurrence or complications incidence in the control group was significantly higher than in the observation group,the difference is statistically significant (P=0.034);by using logistic model stepwise regression analyses,it found that working environment,complications and postoperative comprehensive treatment are the related risk factors of the clinical effect of nasal endoscopic surgery.Conclusion：The curative effect of nasal endoscopic surgery for chronic sinusitis and nasal polyps was significantly better than routine nasal and sinus surgery,and postoperative recurrence rate of patients treated by nasal endoscopic surgery is low and less complications,safety and operability is high,it is worth to be popularized in clinical treatment.

慢性鼻窦炎、鼻息肉是常见的耳鼻喉科疾病，慢性鼻窦炎主要是由于鼻窦的慢性化脓性炎症引起的[1]，鼻息肉主要是由于鼻粘膜长期炎症反应引起组织发生水肿造成的[2]。慢性鼻窦炎、鼻息肉患者病情发展可引起呼吸道感染症状，可能出现颅眼肺并发症，导致视力改变，甚至感染加重而死亡[3]，严重影响了患者的生活质量和身体健康。目前，慢性鼻窦炎、鼻息肉的发病率在逐年上升，一般药物治疗效果往往不理想，常反复发作；而常规手术治疗又容易损伤鼻腔、鼻窦正常的解剖学结构[4]。鼻内镜手术是微创领域的分支，手术操作方便，对鼻腔组织解剖结构损伤小，安全性高效果好[5]。……