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

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2=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.
[1] 宋晓宇, 张宇, 李成林, 宋西成. 加速康复外科理念在慢性鼻-鼻窦炎伴鼻息肉手术治疗中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 9-12.
[2] 马钊恩, 翟锦明, 廖礼兵, 杨震. 咽鼓管球囊扩张术治疗慢性分泌性中耳炎的短期疗效观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 54-56.
[3] 张杰,陈雪梅,许安廷. 超声刀扁桃体切除术与低温等离子扁桃体切除术的对比研究[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 95-100.
[4] 刘洁,施陈燕,张治军. 糠酸莫米松鼻喷剂联合玉屏风颗粒可提高儿童腺样体肥大疗效[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 73-76.
[5] 刘俊茹,高英恺,杨杨,王俊菊,刘存军. 低温等离子刀切除舌根增生性肿物40例报告[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 83-84.
[6] 王雅宁,耿博,李百彦,崔朝阳,王启荣. 鼻咽癌放疗后颅底骨感染坏死的治疗体会[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 42-45.
[7] 栾亚楠, 郭敬丽, 王利华. 人工眼位散开术治疗婴儿眼球震颤综合征(附6例报告)[J]. 山东大学耳鼻喉眼学报, 2015, 29(5): 69-71.
[8] 刘洪, 刘天悦, 王春娇, 王娟. 改进软腭牵拉暴露鼻咽手术治疗腺样体肥大[J]. 山东大学耳鼻喉眼学报, 2015, 29(1): 89-90.
[9] 王永福, 徐永向, 于军, 宇雅平, 陈晓华. 茎突综合征30例手术治疗临床分析[J]. 山东大学耳鼻喉眼学报, 2014, 28(6): 9-10.
[10] 马翔, 郭敬丽, 王利华. 双眼外直肌后徙术治疗儿童类似分开过强型间歇性外斜视22例[J]. 山东大学耳鼻喉眼学报, 2014, 28(5): 62-65.
[11] 周荣金, 王俊国. 鼻咽部肌上皮癌1例报告并文献复习[J]. 山东大学耳鼻喉眼学报, 2014, 28(4): 33-34.
[12] 刘全,吕传桢. 中西医结合治疗儿童慢性鼻窦炎临床疗效观察[J]. 山东大学耳鼻喉眼学报, 2014, 28(1): 46-47.
[13] 万京明. 手术治疗儿童阻塞性睡眠呼吸暂停低通气综合征80例[J]. 山东大学耳鼻喉眼学报, 2013, 27(1): 10-11.
[14] 李树华,石洪金,董卫东,吴大海. 喉源性阻塞性睡眠呼吸暂停低通气综合征的临床观察[J]. 山东大学耳鼻喉眼学报, 2012, 26(6): 1-3.
[15] 唐隽1,李山祥2,肖建新1,张超1, 施思斯1,于青青1,王跃建1. 经睑下缘及内眦切口内镜辅助下眶壁骨折治疗初探[J]. 山东大学耳鼻喉眼学报, 2011, 25(5): 54-.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!