摘要
目的:观察泪前隐窝入路术联合鼻内镜下上颌窦自然口扩大开放术治疗真菌性上颌窦炎患者的效果。方法:选取2019年1月至2020年12月该院收治的137例真菌性上颌窦炎患者进行前瞻性研究,按照随机数字表法分为观察组69例和对照组68例。对照组实施鼻内镜下上颌窦自然口扩大开放术治疗,观察组实施鼻内镜下上颌窦自然口扩大开放术联合泪前隐窝入路术治疗。比较两组手术相关指标(术中失血量、手术时间、住院时间)水平,术前和术后1、3、5 d炎性因子[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平;术后6个月,比较两组治疗总有效率、手术前后病变程度(Lund-Kennedy鼻内镜评分系统)、并发症发生率和复发率。结果:观察组治疗总有效率为97.10%,高于对照组的86.76%,差异有统计学意义(P<0.05);观察组术中失血量少于对照组,手术时间和住院时间均短于对照组,差异有统计学意义(P<0.05);术后1、3、5 d,两组血清IL-1β、TNF-α、CRP水平比较,差异均无统计学意义(P>0.05);术后1、3 d,两组血清IL-1β、TNF-α、CRP水平均高于术前,差异有统计学意义(P<0.05);术后6个月,观察组Lund-Kennedy评分、并发症发生率和复发率均低于对照组,差异有统计学意义(P<0.05)。结论:泪前隐窝入路术联合鼻内镜下上颌窦自然口扩大开放术治疗真菌性上颌窦炎患者,可提高治疗总有效率,改善手术相关指标水平,降低Lund-Kennedy评分、并发症发生率和复发率,效果优于单纯鼻内镜下上颌窦自然口扩大开放术治疗,但降低炎性因子水平的效果不明显。
Objective:To observe effects of prelacrimal recess approach combined with nasal endoscopic maxillary sinus natural ostium enlargement in the treatment of fungal maxillary sinusitis.Methods:137 patients with fungal maxillary sinusitis who were treated in this hospital from January 2019 to December 2020 were selected for the prospective study.According to the random number table method,they were divided into observation group(69 cases)and control group(68 cases).The control group was treated with nasal endoscopic maxillary sinus natural ostium enlargement,while the observation group was treated with nasal endoscopic maxillary sinus natural ostium enlargement combined with prelacrimal recess approach.The levels of surgery-related indicators(intraoperative blood loss,operation time,hospitalization time),the inflammatory factor levels[interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],the total effective rate of treatment 6 months after the surgery,the degrees of lesions before and after the surgery(Lund-Kennedy endoscopic scoring system),the incidence of complications,and the recurrence rate were compared between the two groups.Results:The total effective rate of the observation group was 97.10%,which was higher than 86.76%of the control group,and the difference was statistically significant(P<0.05).The intraoperative blood loss of the observation group was less than that of the control group,the operation time and the hospitalization time were shorter than those of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the serum IL-1β,TNF-αand CRP levels between the two groups 1,3 and 5 days after the surgery(P>0.05).1 and 3 days after the surgery,the serum levels of IL-1β,TNF-αand CRP in the two groups were higher than those before the surgery,and the differences were statistically significant(P<0.05).Further,6 months after the surgery,the Lund-Kennedy score,the incidence of complications and the recurrence rate of the
作者
李毅
LI Yi(Department of Otolaryngology of Nanyang First People's Hospital,Nanyang 473000 Henan,China)
出处
《中国民康医学》
2022年第18期17-20,共4页
Medical Journal of Chinese People’s Health
