摘要
目的 探究保留部分中鼻甲的鼻窦扩大开放术(EESS)在2型炎症慢性鼻窦炎(CRS)中的应用价值。方法 选取2019年6月至2022年6月于河北唐山市人民医院行EESS治疗的2型炎症CRS患者102例,采用随机数字表法分为观察组和对照组,每组51例。对照组行EESS术中进行中鼻甲切除,观察组行EESS术中保留部分中鼻甲。比较两组患者手术前后的炎症指标[外周血嗜酸粒细胞(EOS)及血清白细胞介素-4(IL-4)、IL-5]、病情改善情况[视觉模拟评分(VAS)、Lund-Kennedy、Lund-Mackay评分]、鼻腔功能[鼻腔容积(NCV)、最小横截面积(NMCA)、气道阻力等]及嗅觉功能、围手术期并发症及术后1年复发率情况。结果 观察组术后3个月的EOS、IL-4及IL-5水平均低于对照组,EOS、IL-4及IL-5变化差值均高于对照组(P<0.05);两组术前、术后6个月VAS、Lund-Kennedy及Lund-Mackay评分及其变化差值比较,差异均无统计学意义(P>0.05);观察组术后6个月NCV、NMCA水平及NCV、NMCA气道阻力差值均高于对照组,气道阻力低于对照组(P<0.05);两组均无加重病例,观察组术后6个月嗅觉功能好转患者占比高于对照组(P<0.05);两组患者并发症总发生率(13.73%比17.65%)及术后复发率(23.53%比19.61%),差异无统计学意义(P>0.05)。结论 保留部分中鼻甲的EESS利于2型炎症CRS患者鼻腔功能、嗅觉功能恢复,降低炎性应激反应,不增加复发风险。
Objective To investigate the application of sinus enlargement and opening(EESS)in chronic sinusitis(CRS)with type 2 inflammation.Methods A total of 102 patients with CRS type 2 inflammation who received EESS treatment in Tangshan People’s Hospital of Hebei province from June 2019 to June 2022 were randomly divided into two groups:the control group and the observation group.The control group(n=51)underwent middle turbinectomy during EESS,while the observation group(n=51)underwent partial middle turbinectomy during EESS.The observation group received EESS,and the middle turbinate was preserved during the operation.Inflammatory indicators[Peripheral blood eosinophils(EOS)and serum interleukin-4(IL-4),Interleukin-5(IL-5)],disease improvement[visual analogue score(VAS),Lund-Kennedy,Lund-Mackay scores],nasal function[nasal volume(NCV),minimum cross-sectional area(NMCA),airway resistance,etc.],olfactory function,perioperative complications and one-year postoperative recurrence rate were compared between the two groups before and after sur⁃gery.Results The levels of EOS,IL-4 and IL-5 in the observation group were lower than those in the control group three months after opera⁃tion,and the differences of EOS,IL-4 and IL-5 were higher than those in the control group(P<0.05).There were no significant differences in VAS,Lund-Kennedy and Lund-Mackay scores and their differences before and six months after surgery between the two groups(P>0.05).The levels of NCV and NMCA and the difference of airway resistance between NCV and NMCA in observation group were higher than those in con⁃trol group six months after operation,and the airway resistance was lower than that in control group(P<0.05).There were no aggravation cases in both groups,and the proportion of patients with improved olfactory function in the observation group was higher than that in the control group six months after operation(P<0.05).There was no significant difference in the total incidence of complications(13.73%vs 17.65%)and postop⁃erative recurrence r
作者
张立杰
彭军
张卫朋
柳淑洪
唐立滨
ZHANG Lijie;PENG Jun;ZHANG Weipeng;LIU Shuhong;TANG Libin(Department of Otolaryngology-Head and Neck Surgery,Tangshan People’s Hospital,Tangshan 063000,China)
出处
《安徽医学》
2024年第12期1497-1501,共5页
Anhui Medical Journal
基金
河北省医学科学研究课题计划(编号:20241591)~~。
关键词
慢性鼻窦炎
2型炎症
鼻窦扩大开放术
保留
中鼻甲
Chronic sinusitis
Type 2 inflammation
Extended endoscopic sinus surgery
Reserve
Middle nasal concha
