山东大学耳鼻喉眼学报 ›› 2014, Vol. 28 ›› Issue (4): 35-39.doi: 10.6040/j.issn.1673-3770.0.2014.179

• 论著 • 上一篇    下一篇

鼻窦球囊扩张术治疗慢性上颌窦炎的非随机对照前瞻性临床研究

蒋路云1, 刘洋2, 谢艳1, 谢慧1, 周立1   

  1. 1. 成都中医药大学附属医院耳鼻咽喉头颈外科, 四川 成都 610072;
    2. 成都中医药大学第一临床学院, 四川 成都 610072
  • 收稿日期:2014-05-27 出版日期:2014-08-16 发布日期:2014-08-16
  • 通讯作者: 刘洋。E-mail:liuyang_19861010@163.com E-mail:liuyang_19861010@163.com
  • 作者简介:蒋路云。E-mail:jly666@163.com
  • 基金资助:
    四川省卫生厅科研课题(120464)

Sinus balloon dilatation for the treatment of chronic maxillary sinusitis:a nonrandomized control prospective clinical study

JIANG LU-yun1, LIU Yang2, XIE Yan1, XIE Hui1, ZHOU Li1   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery, Teaching Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan, China;
    2. First Clinincal College, Chengdu University of Traditional Chinese Medicine, Chengdu 610072, Sichuan, China
  • Received:2014-05-27 Online:2014-08-16 Published:2014-08-16

摘要: 目的 评价鼻窦球囊扩张术与传统鼻内镜鼻窦开放术治疗慢性上颌窦炎的临床疗效、安全性及患者接受程度的差异。方法 将50例慢性上颌窦炎患者随机均分入两组,其中A组25例行鼻窦球囊扩张术,B组25例行鼻内镜下上颌窦开放术。术后随访12个月,评价临床疗效、安全性、患者手术舒适度。结果 术后检查及随访期间,A组脱落病例2例,B组脱落病例3例,共对45例患者进行评价。45例患者症状均明显改善,术后鼻内镜检查A组开放的33个窦口中有30个窦口开放、黏膜恢复良好,1个窦口狭窄,2个窦口周围黏膜水肿;B组开放的32个窦口中,27个开放完好,2个窦口狭窄,3个窦口黏膜水肿。两组患者术后均无视力改变、眼部肿胀及脑脊液鼻漏等其他并发症发生。A组与B组术后3个月、随访结束(术后12个月)SNOT-20评分以及CT评分均无统计学差异;术后3个月、随访结束后(术后12个月)Lund -Kennedy内镜黏膜形态评分得分以及手术舒适度评分(出院当天)A组明显优于B组(P<0.05)。结论 鼻窦球囊扩张术与传统内镜在治疗慢性上颌窦炎方面均具有较好的临床疗效及安全性,但在术后远期黏膜恢复及手术舒适度方面,鼻窦球囊扩张术明显优于传统鼻内镜手术,值得临床推广及应用。

关键词: 鼻内镜手术, 对照研究, 鼻窦球囊扩张术, 鼻窦炎

Abstract: Objective To evaluate the curative effect, safety and degree of patients' accept of the sinus of balloon dilatation in the treatment of chronic maxillary sinusitis in. Methods 50 patients with chronic maxillary sinusitis were randomly divided into two groups on average: group A of 25 patients with sinus balloon dilatation and group B of 25 with maxillary sinus endoscopic operation. Results In examination and post-operative follow-up period of 1 year, there were 2 cases fell off in group A and 3 cases in group B. The 23 cases in group A and 22 cases in group B with clinical symptoms were significantly improved. Through post-operative nasal endoscopic examination, the group A's patency of maxillary sinus ostium maintained well in 30 cases, sinus stenosed in 1 case and sinus mucosa edema around in 2 cases; the group B's patency of maxillary sinus ostium maintained well in 27 cases, sinus stenosed in 2 cases and sinus mucosa edema around in 3cases. There were no post-operative complications of eyes and cerebrospinal fluid leak occurred in two groups. The grades of CT scores of post-operation 12months, and SNOT-20 of post-operative 3 months and 12 months had no significant differences between the group A and B. The Lund -Kennedy endoscopic mucosal morphology scores of post-operative 3 months and 12 months, and the comfort score (the day discharged from hospital after recovery) in group A were better than in group B(P<0.05). Conclusion The nasal endoscopic balloon dilatation and traditional functional endoscopic sinus surgery have the same therapeutic effect and safety in chronic maxillary sinusitis. But in aspect of long-term curative effect and operation comfort, balloon dilatation is better than traditional nasal endoscopic sinus surgery and worthy of clinical popularization and application.

Key words: Control study, The nasal endoscopic surgery, Sinus balloon dilatation, Sinusitis

中图分类号: 

  • R765.4+2
[1] 中华医学会耳鼻咽喉头颈外科分会, 中华耳鼻咽喉头颈外科杂志编委会.慢性鼻-鼻窦炎诊断和治疗指南[J].中华耳鼻咽喉头颈外科杂志, 2009, 44(1):6-7.
[2] Friedman M, Sehalch P. Functional endoscopic dilatation of the sinuses(FEDS):patient selection and surgical technique[J].Otolaryngol Head Neck Surg, 2006, 179(2):125-134.
[3] Lanza D C, Kennedy D W. Balloon sinuplasty:not ready for prime time[J].Ann Otol Rhinol Laryngol, 2006, 115(8):789-790.
[5] Brown C L, Bolger W E. Safety and feasibility of balloon catheter dilation of paranasal sinus ostia: a preliminary investigation[J].Ann Otol Rhinol Laryngol, 2006, 115 (4):293-299.
[6] Bolger W E, Brown C L, Church C A, et al. Safety and outcomes of balloon catheter sinusotomy: a multicenter 24 -week analysis in 115 patients[J]. Otolaryngol Head Neck Surg, 2007, 137(1): 10-20.
[7] Levine H L, Sertich A P, Hoisington D R, et al. Multicenter registry of balloon catheter sinusotomy outcomes for 1036 patients[J]. Ann Otol Rhinol Laryngol, 2008, 117(4):263-270.
[8] Kuhn F A, Church C A, Goldberg A N, et al. Balloon catheter sinusotomy:one-year follow-up-outcomes and role in functional endoscopic sinus surgery[J].Otolaryngol Head Neck Surg, 2008, 139(1):27-37.
[9] Weiss R L, Church C A, Kuhn F A, et al. Long-term outcome analysisof balloon catheter sinusotomy:two-year follow-up[J]. Otolaryngol Head Neck Surg, 2008, 139(1):38-46.
[1] 冯思聪,于晓岚,娄丹. 基于囊泡组织Ki67、GM-CSF表达评估Messerklinger中鼻甲成形术对慢性鼻-鼻窦炎合并鼻息肉的效果[J]. 山东大学耳鼻喉眼学报, 2026, 40(3): 31-39.
[2] 翟雪纯,边欣,陈敬彩,邓家钰,叶子,杨萍丽. 慢性额窦炎患者焦虑抑郁特点及横断面研究[J]. 山东大学耳鼻喉眼学报, 2026, 40(2): 35-43.
[3] 李阳松,袁发洋,杨艳,张田,喻国冻. 基于Web of Science进行生物制剂治疗慢性鼻窦炎文献计量学分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 54-64.
[4] 杜康丽,郑振宇,徐战将,张宇,陈露,卢梦垚. 鼻中隔偏曲并发慢性鼻窦炎风险预测模型的构建与验证[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 78-86.
[5] 熊琴, 张砚, 乌日娜, 李锋, 唐力行. 鼻用糖皮质激素在儿童中的应用[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 160-167.
[6] 黄焕,华红利,邓玉琴,江承洋,王雨薇,杨星海. 儿童过敏性鼻炎、扁桃体腺样体肥大和鼻窦炎之间相关性及其对临床指导价值[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 34-41.
[7] 张家齐,袁野,洪陈,顾敏,程雷,陆美萍. 基于孟德尔随机化的肠道菌群与慢性鼻窦炎鼻息肉的因果关系及代谢物中介研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 49-60.
[8] 王再兴,唐志元,李定波,石照辉,曾宪海,张秋航. 鼻咽癌放疗后肿瘤复发及颅底骨坏死引起颈内动脉破裂的治疗方案[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 49-58.
[9] 郭荣昌,刘晴航,王洪增,孙树军. 巨大鼻眼贯通、颅底嵌顿异物损伤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(4): 135-141.
[10] 林育珊,卢标清. 巴曲酶个性化用药治疗全频下降型突聋[J]. 山东大学耳鼻喉眼学报, 2025, 39(3): 115-121.
[11] 张广玲,陈兴雪,武天义,孙占伟,王卫卫,李世超,王广科. Tespa1在慢性鼻窦炎伴鼻息肉中的表达及作用研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 35-42.
[12] 曹正勇,李小波. 慢性鼻-鼻窦炎合并哮喘术后短程局部使用糖皮质激素辅助治疗的安全性和有效性[J]. 山东大学耳鼻喉眼学报, 2025, 39(2): 43-50.
[13] 王文晴,张丹,朱梦迪,王路阳,杨培培,孙思思,张秋敏,周慧. 慢性鼻窦炎伴鼻息肉复发手术时临床及组织病理学特征变化[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 46-53.
[14] 王奥维,时文杰. CRSwNP中医证型与TFH细胞相关因子的相关性研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 54-60.
[15] 张婕,尼玛吉宗,徐小东,周菁,刘建敏,罗依蕤,杜进涛,巴罗. 藏红花素在嗜酸性慢性鼻窦炎伴鼻息肉中调控2型炎症反应的研究[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 61-67.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!