儿童上颌窦后鼻孔息肉36例临床资料分析

doi:10.6040/j.issn.1673-3770.0.2022.218

摘要/Abstract

摘要： 目的探讨鼻窦载药缓释植入系统在儿童上颌窦后鼻孔息肉手术治疗中的安全性和有效性。方法收集儿童上颌窦后鼻孔息肉36例并随访其预后情况,根据上述病例在手术中是否使用鼻窦载药缓释系统分为研究组(26例)和对照组(10例)。随访时间为术后第1、3、6个月,采用Lund-Kennedy评分法、视觉模拟量表评分进行术后术腔黏膜和症状评估。结果研究组平均(8.51±2.76)岁,对照组平均(7.80±2.76)岁,两者年龄差异无统计学意义(P=0.525)。两组男女比例无统计学意义(P=0.854)。术后1个月、3个月随访,两组间症状评分无统计学意义(P=0.485、P=0.113),但随访至6个月时,研究组病例症状评分较对照组显著改善(P<0.05)。术后1个月随访时研究组术腔Lund-Kennedy评分显著好于对照组(P<0.05),但随访至3、6及12个月时,两者无统计学意义(P=0.158、P=0.087、P=0.555)。研究组和对照组各有1例复发(3.85%/10%),两者无统计学意义(P=0.484)。研究组和对照组病例术后均未出现眶内及颅内并发症。结论儿童上颌窦后鼻孔息肉手术治疗中应用鼻窦载药缓释植入系统能够在一定程度上促进术后症状改善及术腔愈合;利于保持窦口通畅引流,对儿童上颌窦后鼻孔息肉术后恢复有一定积极作用。但复发率结果尚无统计学意义,需更大样本量的临床研究加以验证。鼻窦载药缓释植入系统在本研究中未造成术后并发症的增加。

关键词: 上颌窦后鼻孔息肉, 鼻窦可吸收类固醇缓释植入物, 儿童, 鼻内镜手术, 疗效评价

Abstract: Objective This paper explored the safety and efficacy of sinus absorbable steroid sustained-release implantation system in the treatment of antrochoanal polyp in children. Methods A total of 36 pediatric patients with antrochoanal polyps were divided into study group(26 cases)and control group(10 cases), depending on whether or not a sinus absorbable steroid sustained-release implantation system was implanted into the sinus cavity. All the patients were followed up for half a year. Visual analogue scale and Lund-Kennedy score were used to evaluate the symptoms and mucous membrane of the operative cavity. Results The mean age of the study group was(8.51±2.76)years, and that of the control group was(7.80±2.76)years, with no statistical difference(P=0.525). There was no significant difference in male/female ratio between the two groups(P=0.854). There was no significant difference in the symptom score between the two groups at one and three months of follow-up after the operation(P=0.485; P=0.113, respectively), but the symptom score of the study group was significantly improved compared with the control group at six months after the operation(P<0.05). The Lund-Kennedy score of the study group was significantly better than that of the control group at one month of follow-up(P<0.05), but there was no significant difference at 3, 6, and 12 months of follow-up(P=0.158, P=0.087, and P=0.555, respectively). There was respectively one case of recurrence in the study and control groups(3.85%/10%), with no statistical difference between the two groups(P=0.484). There were no intra-orbital and intra-cranial complications in the study and control groups. Conclusion In the surgical treatment of children with antrochoanal polyps, the application of sinus absorbable steroid sustained-release implantation system can effectively improve postoperative symptoms and operative cavity conditions. However, there was no statistical difference in recurrence rate, which needs to be verified by further clinical studies with a larger sample size. There was no increase in postoperative complications associated with sinus stents in this study.

Key words: Antrochoanal polyp, Bioabsorbable steroid-eluting sinus implants, Children, Nasal endoscopic surgery, Evaluation of therapeutic efficiency

中图分类号:

R765.21

徐宏鸣,范文焱,浦诗磊,李晓艳. 儿童上颌窦后鼻孔息肉36例临床资料分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 159-163.

XU Hongming, FAN Wenyan, PU Shilei, LI Xiaoyan. Clinical data analysis of 36 cases of antrochoanal polyp in Children[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 159-163.

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