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根治性鼻内镜手术治疗嗜酸粒细胞增高型慢性鼻窦炎伴鼻息肉的疗效分析 被引量:10

Curative effect analysis of radical endoscopic sinus surgery for eosinophilic chronic rhinosinusitis with nasal polyps
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摘要 目的:探讨嗜酸粒细胞型慢性鼻窦炎伴鼻息肉(EosCRSwNP)的功能性内镜鼻窦手术(FESS)与根治性内镜鼻窦手术(RESS)的疗效。方法:纳入2020年7月1日—2021年8月1日在河南省人民医院耳鼻咽喉头颈外科诊断为EosCRSwNP的患者44例,嗜酸粒细胞占白细胞的百分比均超过3.05%,将患者按照随机数字表分为FESS组和RESS组,对比两组患者术前、术后1个月、术后3个月、术后6个月及术后1年的视觉模拟评分量表(VAS)、鼻内镜Lund-Kennedy评分和鼻腔鼻窦结局测试22(SNOT-22)的差异。结果:术后1年两组患者各项评分均较术前明显改善,且差异有统计学意义(均P<0.01);两组患者间鼻内镜评分、VAS评分及SNOT-22评分差异均有统计学意义(P=0.01,P=0.03,P=0.03)。RESS组复发率26.09%(6/23),FESS组复发率61.90%(13/21),差异有统计学意义(P=0.04)。结论:RESS和FESS均有助于改善EosCRSwNP患者的鼻部症状,促进嗅觉恢复,但RESS在减少复发、改善患者预后方面更有优势。 Objective:To evaluate the efficacy of functional endoscopic sinus surgery(FESS)and radical endoscopic sinus surgery(RESS)in eosinophilic chronic sinusitis with nasal polyps(EosCRSwNP).Methods:A total of 44 patients diagnosed with EosCRSwNP in the Department of Otorhinolaryngology Head and Neck Surgery,Henan Provincial People’s Hospital from July 1 st,2020 to August 1 st,2021 were included,the percentage of eosinophils in leukocytes in all patients included was more than 3.05%.The patients were randomly divided into FESS group and RESS group according to random number table.The visual analogue scale(VAS)score,Lund-Kennedy score and sino-nasal outcome test-22(SNOT-22)were compared between the two groups before operation,1 month,3 months,6 months and 1 year after operation.Results:At 1 year after operation,the scores of the two groups were significantly improved compared with those before operation,and the differences were statistically significant(P<0.01).There were significant differences in nasal endoscopic score,VAS score and SNOT-22 score between the two groups(P=0.01,P=0.03,P=0.03).The recurrence rate of RESS group was 26.09%(6/23)and that of FESS group was 61.90%(13/21),and the difference was statistically significant(P=0.04).Conclusion:Both RESS and FESS can improve nasal symptoms and promote olfactory recovery in EosCRSwNP patients,but RESS has more advantages in reducing recurrence and improving the prognosis of patients.
作者 汪文华 王广科 武天义 孙占伟 王卫卫 李世超 WANG Wenhua;WANG Guangke;WU Tianyi;SUN Zhanwei;WANG Weiwei;LI Shichao(Department of Otorhinolaryngology Head and Neck Surgery,Zhengzhou University People's Hospital,Henan Provincial People's Hospital,Zhengzhou,450003,China)
出处 《临床耳鼻咽喉头颈外科杂志》 CAS CSCD 北大核心 2023年第1期20-24,共5页 Journal of Clinical Otorhinolaryngology Head And Neck Surgery
基金 河南省2022年科技发展计划(No:222102310203)。
关键词 鼻窦炎 鼻息肉 根治性内镜鼻窦手术 功能性内镜鼻窦手术 sinusitis nasal polyps radical endoscopic sinus surgery functional endoscopic sinus surgery
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