山东大学耳鼻喉眼学报 ›› 2018, Vol. 32 ›› Issue (5): 82-85.doi: 10.6040/j.issn.1673-3770.0.2018.176

• ·论著· • 上一篇    下一篇

鼻内镜下中鼻甲功能性部分切除治疗慢性鼻窦炎76例分析

沈勤峰1,沈小燕1,朱荣强1,蒋斐斐1,郎军添2   

  1. 1.苏州市吴江区中医医院 吴江区第二人民医院耳鼻咽喉-头颈外科, 江苏 吴江 215221;
    2.海军军医大学上海长征医院耳鼻咽喉科, 上海 200003
  • 收稿日期:2018-04-09 出版日期:2018-09-20 发布日期:2018-09-20
  • 通讯作者: 郎军添. E-mail:wolfjt3610@hotmail.com

Role of functional middle turbinectomy in functional endoscopic sinus surgery for chronic sinusitis

SHEN Qinfeng1, SHEN Xiaoyan1, ZHU Rongqiang1, JIANG Feifei1, LANG Juntian2   

  1. Department of Otolaryngology, Shanghai Changzheng Hospital, Naval Military Medical University, Shanghai 200003, China
  • Received:2018-04-09 Online:2018-09-20 Published:2018-09-20

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摘要： 目的 观察鼻内镜手术中鼻甲功能性部分切除对于有中鼻甲病变的慢性鼻窦炎伴鼻息肉患者的疗效。 方法 2014年1月至2017年1月收治的76例慢性鼻窦炎伴鼻息肉患者行功能性鼻内镜手术。依中鼻甲有无病变及是否行中鼻甲切除分为观察组(n=38)与对照组(n=38),观察两组手术时间、疗效、中鼻甲粘连和术后主观症状评分。 结果 观察组手术时间为(50.53±6.25)min、对照组为(58.11±6.09)min,差异有统计学意义(t=5.355, P<0.001);术后随访6个月,两组患者治疗有效率均为100%,其中对照组的治愈率为78.95%(30/38),观察组为81.58%(31/38),差异无统计学意义(P>0.05);术后中鼻甲粘连率(χ2=4.155, P=0.042)和主观症状评分差异有统计学意义(Z=3.68, P=0.031)。 结论 对有中鼻甲病变的慢性鼻窦炎伴鼻息肉患者实施鼻内镜手术时行功能性部分中鼻甲切除,能明显缩短患者手术时间、减少中鼻甲粘连率、改善患者的主观症状。

关键词: 功能性鼻内镜手术, 治疗结果, 中鼻甲

Abstract: Objective To explore the efficacy of partial middle turbinectomy in endoscopic sinus surgery for chronic sinusitis with nasal polyps. Methods A total of 76 patients with chronic sinusitis and nasal polyps accepted functional nasal endoscopic surgery(FESS)from January 2014 to January 2017. Patients were divided into two groups randomly. One group of 38 patients underwent usual FESS surgery with the middle turbinate preserved, while the other group of 38 patients underwent FESS with middle turbinate removed. The cure rate, operation time, middle turbinectomy adhesion, symptom scoring and olfactory function were investigated and statistically analyzed. Results The operation time was(50.53±6.25)minutes in middle turbinate resection group, and(58.11±6.09)minutes in the other group(t=5.355, P<0.001). Six months after surgery, both groups had 100% effective outcome. The cure rate of the turbinate-preserved group was 78.95%(30/38)and of the resection group was 81.58%(31/38). After surgery, there was a significant difference for patents symptom scoring and middle turbinate adhesion between the two groups, which was much better in middle turbinate resection group. Conclusion Partial removing middle turbinate can shorten the time of nasal endoscopic surgery and middle turbinate adhesion, improving patients subjective feeling. It is suggested that for patients with moderate middle turbinate hypertrophy and polypoid changes, the lesioned middle turbinate need to be removed appropriately in functional endoscopic sinus surgery.

Key words: Middle turbinate, Treatment outcome, Functional Endoscopic Sinus Surgery

中图分类号: 

  • R765.2
[1] Ponikau JU, Sherris DA, Kephart GM, et al. Features of airway remodeling and eosinophilic inflammation in chronic rhinosinusitis: is the histopathology similar to asthma?[J]. J Allergy Clin Immunol, 2003, 112:877-882.
[2] 王道本,陆允伟,周明,等. 功能性内窥镜鼻窦手术切除和保留中鼻甲对疗效的影响[J]. 上海医学,2001,24(6):366-369. WANG Daoben, LU Yunwei, ZHOU Ming, et al. Comparison of affect of functional endonasal sinus surgery with and without partial middle turbinate resection[J]. Shanghai MED J, 2001, 24(6):366-369.
[3] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.慢性鼻-鼻窦炎诊断和治疗指南(2012年,昆明)[J].中华耳鼻咽喉头颈外科杂志,2013,48(2):92-94. Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery; Subspecialty Group of Rhinology, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association. Guidelines for diagnosis and treatment of chronic rhinosinusitis(2012, Kunming)[J]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2013, 48(2):92-94.
[4] 陈禹潭,曹金红,梁耕田,等.慢性鼻-鼻窦炎伴鼻息肉患者主观评分的相关性分析[J].中华耳鼻咽喉头颈外科杂志,2013,48(4):335-336. CHEN Yutan, CAO Jinhong, LIANG Gengtian, et al. Correlation analysis of subjective and objective scoring of chronic rhinosinusitis with nasal polyps[J]. Chin J Otorhinolaryngol Head Neck Surg, 2013, 48(4):335-336.
[5] 左可军,许庚,史剑波,等.内镜鼻窦手术治疗慢性鼻-鼻窦炎临床结局的主客观评估[J].中华耳鼻咽喉头颈外科杂志,2008,43(1):7-12. ZUO Kejun, XU Geng, SHI Jianbo, et al. Subjective and objective clinical outcome assessment on chronic rhinosinusitis following endoscopic sinus surgery[J]. Chin J Otorhinolaryngol Head Neck Surg, 2008, 43(1):7-I2.
[6] 吉晓滨,梁赐芳,吴晓钟,等.修正性鼻内窥镜手术面临问题及对策[J].广东医学,2004,25(10):1183.
[7] Soler ZM, Hwang PH, Mace J, et al. Outcomes after middle turbinate resection:revisiting acontroversial topic[J]. Laryngoscope, 2010, 120(4):832-837.
[8] 王明婕, 林枫, 张晓晴,等. 功能性鼻内镜手术与轮廓化鼻内镜手术治疗难治性鼻窦炎的疗效分析[J]. 临床耳鼻咽喉头颈外科杂志,2016,31(3):185-190. WANG Mingjie, LIN Feng, ZHANG Xiaoqing, et al. Analysis of surgical outcomes of functional endoscopic sinus surgery and radical sinus surgery for refractory rhinosinusitis[J]. J Clin Otorhinolaryngol Head Neck Surg, 2016, 31(3):185-190.
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