摘要
目的探究鼻内镜修正性手术(RESS)联合中鼻甲切除(MT)治疗难治性鼻-鼻窦炎(RRS)患者的效果及术后复发情况。方法选取2019年1月~2021年1月我院收治的200例RRS患者作为研究对象,按随机数字表法分成观察组和对照组,每组各100例。对照组接受内窥镜鼻窦术(ESS)治疗,观察组接受RESS联合MT治疗。对比两组手术效果、手术前后临床症状评分、鼻气道阻力(NAR)、嗅觉功能、鼻内镜检查量化评估评分(Lund-kennedy)、炎性因子水平[白细胞介素-5(IL-5)、白细胞介素-8(IL-8)、C-反应蛋白(CRP)]、并发症发生率。随访6个月,统计两组复发情况。结果对照组手术优良率83.00%、并发症发生率16.00%、术后6个月复发率14.46%,观察组分别为97.00%、3.00%、1.03%,两组比较差异有统计学意义(P<0.05);与对照组相比,术后3个月观察组嗅觉障碍、脓涕、鼻塞、疼痛评分、NAR、嗅觉功能、Lund-kennedy评分更低,差异均有统计学意义(P<0.05);观察组血清IL-5、CRP、IL-8水平更低,差异均有统计学意义(P<0.05)。结论与ESS相比,应用RESS联合MT治疗RRS患者,在提升手术效果、改善临床症状、提高嗅觉及鼻腔黏膜功能、降低NAR、减少并发症、降低复发率、缓解炎性反应方面更具优势。
Objective To investigate the effect of revision endoscopic sinus surgery(RESS)combined with middle turbinate resection(MT)in the treatment of refractory rhinosinusitis(RRS)patients and their postoperative recurrence.Methods A total of 200 RRS patients treated in our hospital from January 2019 to January 2021 were selected as the research subjects,and randomly divided into observation group and control group,with 100 cases in each group.The control group received endoscopic sinus surgery(ESS)treatment,and the observation group received RESS combined with MT treatment.The surgical effect,clinical symptom scores before and after surgery,nasal airway resistance(NAR),olfactory function,nasal endoscopy quantitative evaluation score(Lund-Kennedy),inflammatory factor levels[interleukin-5(IL-5),interleukin-8(IL-8),C-reactive protein(CRP)],complication rate were compared between the two groups.After 6 months of follow-up,the recurrence rates of the two groups were calculated.Results The excellent and good rate of surgery in the control group was 83.00%,the complication rate was 16.00%,and the recurrence rate at 6 months after surgery was 14.46%.The corresponding rates in the observation group were 97.00%,3.00%,and 1.03%,respectively.There were significant differences between the two groups(P<0.05).Compared with the control group,the scores of olfactory dysfunction,pus discharge,nasal congestion,pain,NAR,olfactory function,Lund-Kennedy in the observation group were lower at 3 months after operation,and the differences were statistically significant(P<0.05).The levels of serum IL-5,CRP,IL-8 in the observation group were lower,and the differences were statistically significant(P<0.05).Conclusion Compared with ESS,RESS combined with MT has more advantages in improving surgical effect,clinical symptoms,olfactory and nasal mucosa function,reducing NAR,reducing complications,recurrence rate and inflammatory response in the treatment of RRS patients.
作者
梁远远
Liang Yuanyuan(Puyang People's Hospital,Puyang 457000,China)
出处
《华北理工大学学报（医学版）》
2024年第1期28-33,共6页
Journal of North China University of Science and Technology：Health Sciences Edition
关键词
鼻内镜修正性手术
中鼻甲切除
难治性鼻-鼻窦炎
Revision endoscopic sinus surgery
Middle turbinate resection
Refractory rhinosinusitis
