摘要
目的探讨鼻内镜手术中的中鼻甲处理技巧和意义。方法回顾性分析收治的80例慢性鼻窦炎、鼻息肉患者随机分为观察组32例(39侧)和对照组48例(54侧),观察组强调中鼻甲的处理上尽可能保障中鼻甲空间结构和形态上的相对正常;对照组采用传统的Messerklinger术或wigand术式。术后6个月对比两组中鼻甲的稳定性,中鼻道狭窄或粘连的发生情况以及按lund-Kennedy内镜黏膜形态评分系统进行评价。结果两组患者的术前lund-Kennedy内镜黏膜形态评分差异无统计学意义(t=1.659,P>0.05),观察组术后6个月Lund-Kennedy评分为(1.89±1.31)分,低于对照组(2.48±1.42)分,两组比较差异具有统计学意义(t=8.1,P<0.01)。术后观察组中鼻甲结构良好稳定,中鼻甲轻度外移、中鼻道狭窄、中鼻甲与鼻腔外侧壁粘连3种情况的发生率分别为83.2%、4.1%、6.7%,对照组的发生率分别为44.9%、21.6%、10.3%,两组比较差异具有统计学意义(χ2=10.77,P<0.01)。结论保障中鼻甲空间结构和形态上的相对正常有助于提高鼻内镜手术疗效,减少术后不良并发症。
Objective To investigate the skill and significance of middle turbinate processing in endoscopic sinus surgery. Methods 80 patients with chronic sinusitis and nasal polyp were randomly divided into observation group （32 cases, 39 sides ） and control group （48 cases, 54 sides ）. Protection of the spatial structure and morphology of middle turbinate was enhanced as much as possible during endoscopic sinus surgery in patients of the observation group, while the patients of the control group received traditional Messerklinger or Wigand surgery. Six months after surgery, the stability of the middle turbinate, the occurrence of stenosis or adhension of middle meatus, and the mucosal evaluation according to the Lund-Kennedy endoscopic mucosal morphology scoring system between the two groups were compared. Results The difference of preoperative Lund-Kennedy scores between the two groups was statistically insignificant （t = 1. 659, P 〉 0.05 ） ; 6 months after surgery, the score of the observation group （ 1.89±1.31 ） was much less than that of the control group（ 2.48±1.42 ） and the difference was statistically significant （t = 8. 1 , P 〈 0.01 ）. In the patients of the observation group, the middle turbinate was stable, the occurrence rates of slight relocation, middle meatus stenosis and adhension were 83.2% , 4. 1% and 6.7 % respectively, while those of the control group were 44.9% , 21.6% and 10.3% . The differences of above-mentioned rates between the two groups were statistically significant （X2 = 10.77, P 〈 0.01 ）. Conclusion To retain the relatively normal morphology and spatial structure of middle turbinate may be helpful to improve the clinical efficacy and to decrease the postoperative complications in endoscopic sinus surgery.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2013年第5期430-432,共3页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
关键词
中鼻甲
鼻内镜手术
鼻窦炎
Middle turbinate
Endoscopic sinus surgery
Sinusitis
