改良鼻丘径路额窦开放为主修正手术联合中鼻甲全部或部分切除在难治性鼻窦炎治疗中的应用效果

    Application effect of modified nasal hill path frontal sinus correction surgery combined with all or part middle turbinate resection in the treatment of refractory sinusitis

    • 摘要: 目的:探讨改良鼻丘径路额窦开放为主修正手术联合中鼻甲全部或部分切除治疗难治性鼻窦炎(RRS)的临床效果。方法:选取42例RRS患者作为研究对象,采用改良鼻丘径路额窦开放为主修正手术联合中鼻甲全部或部分切除治疗,其中26例合并鼻中隔偏曲的患者采用内镜下传统矫正切除,16例合并变应性鼻炎的患者采用黏膜电凝术治疗,观察患者治疗前后的临床症状、生活质量等指标的改善情况。结果:患者手术后1个月、6个月鼻塞、鼻漏、嗅觉减退或障碍、面部疼痛或压迫感临床症状视觉模拟评分均显著低于手术前(P<0.01)。患者手术后1个月、6个月的SNOT-20量表评分总分、躯体症状、精神功能评分均明显低于手术前(P<0.01)。患者手术后1、6个月的鼻黏膜纤毛传输速率值均显著的低于手术前(P<0.01)。患者手术后达到治愈17例(40.48%)、好转21例(50.00%)、无效4例(9.52%)。结论:改良鼻丘径路额窦开放为主修正手术联合中鼻甲全部或部分切除治疗RRS患者能够显著改善患者的临床症状等指标,治疗效果确切。

       

      Abstract: Objective: To investigate the clinical effects of modified nasal hill path frontal sinus correction surgery combined with all or part middle turbinate resection in the treatment of refractory sinusitis(RRS).Methods: Forty-two RRS patients were treated with modified nasal hill path frontal sinus correction surgery combined with all or part middle turbinate resection.Among the patients,26 cases with nasal septum deflection were treated with traditional correction resection under endoscopy,and 16 cases with allergic rhinitis were treated with the mucosa electrocoagulation.The clinical symptoms and quality of life in all patients between before and after treatment were compared.Results: The visual analogue scale(VAS) scores of nasal obstruction,rhinorrhea,olfactory loss or disorder and facial pain or oppress sense in of patients at post-operative 1 and 6 months were significantly lower than those in pre-operation(P<0.01).The total scores of SNOT-20,somatic symptom score and mental function score of patients at post-operative 1 and 6 months were significantly lower than those in pre-operation(P<0.01).The nasal mucocilia transfer rate(MTR) value of patients at post-operative 1 and 6 months were significantly lower than those in pre-operation(P<0.01).After the operation,the healing in 17 cases(40.48%),improvement in 21 cases(50.00%) and ineffectiveness in 4 cases(9.52%) were identified.Conclusions: The modified nasal hill path frontal sinus correction surgery combined with all or part middle turbinate resection in treating the RRS can significantly improve the clinical symptoms,the effect of which is good.

       

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