国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
11期
1569-1572
,共4页
鼻内镜%开窗%慢性上颌窦炎
鼻內鏡%開窗%慢性上頜竇炎
비내경%개창%만성상합두염
Nasal endoscopy%Window modes%Chronic maxillary sinusitis
目的 探讨鼻内镜下手术不同开窗方式治疗慢性上颌窦炎的手术途径及临床疗效.方法 选取我院240例已确诊慢性上颌窦炎患者,根据治疗方法的不同将其随机分为经下鼻道上颌窦开窗术治疗组(Ⅰ组)、经中鼻道上颌窦口开窗术治疗组(Ⅱ组)、双径路上颌窦病变清除术治疗组(Ⅲ组).通过术后回访比较鼻内镜下手术3种开窗方式治疗慢性上颌窦炎在各组中的手术途径及临床疗效.结果 3组共240例患者经治疗后鼻塞、流涕、嗅觉减退和头痛等症状均基本消失,术后经鼻内镜和鼻窦CT冠状位加水平位扫描复查,定期随访,其中Ⅰ组80例痊愈46例,好转30例,治愈率为57.5％,Ⅱ组120例痊愈78例,好转30例,治愈率为65％,Ⅲ组40例痊愈32例,好转8例,治愈率为80％,Ⅲ组临床疗效显著优于Ⅰ组、Ⅱ组,各组结果比较差异具有统计学意义(P＜0.05).Ⅲ组术后的鼻腔-鼻窦结局测试评分显著优于Ⅰ组、Ⅱ组,各组手术前后的鼻腔-鼻窦结局测试评分差异均具有显著性(P＜0.05).结论 采用鼻内镜下手术治疗慢性上颌窦炎,疗效确切,患者预后理想,而选择双径路开窗上颌窦病变清除术治疗更能提高治愈率,值得临床推广使用.
目的 探討鼻內鏡下手術不同開窗方式治療慢性上頜竇炎的手術途徑及臨床療效.方法 選取我院240例已確診慢性上頜竇炎患者,根據治療方法的不同將其隨機分為經下鼻道上頜竇開窗術治療組(Ⅰ組)、經中鼻道上頜竇口開窗術治療組(Ⅱ組)、雙徑路上頜竇病變清除術治療組(Ⅲ組).通過術後迴訪比較鼻內鏡下手術3種開窗方式治療慢性上頜竇炎在各組中的手術途徑及臨床療效.結果 3組共240例患者經治療後鼻塞、流涕、嗅覺減退和頭痛等癥狀均基本消失,術後經鼻內鏡和鼻竇CT冠狀位加水平位掃描複查,定期隨訪,其中Ⅰ組80例痊愈46例,好轉30例,治愈率為57.5％,Ⅱ組120例痊愈78例,好轉30例,治愈率為65％,Ⅲ組40例痊愈32例,好轉8例,治愈率為80％,Ⅲ組臨床療效顯著優于Ⅰ組、Ⅱ組,各組結果比較差異具有統計學意義(P＜0.05).Ⅲ組術後的鼻腔-鼻竇結跼測試評分顯著優于Ⅰ組、Ⅱ組,各組手術前後的鼻腔-鼻竇結跼測試評分差異均具有顯著性(P＜0.05).結論 採用鼻內鏡下手術治療慢性上頜竇炎,療效確切,患者預後理想,而選擇雙徑路開窗上頜竇病變清除術治療更能提高治愈率,值得臨床推廣使用.
목적 탐토비내경하수술불동개창방식치료만성상합두염적수술도경급림상료효.방법 선취아원240례이학진만성상합두염환자,근거치료방법적불동장기수궤분위경하비도상합두개창술치료조(Ⅰ조)、경중비도상합두구개창술치료조(Ⅱ조)、쌍경로상합두병변청제술치료조(Ⅲ조).통과술후회방비교비내경하수술3충개창방식치료만성상합두염재각조중적수술도경급림상료효.결과 3조공240례환자경치료후비새、류체、후각감퇴화두통등증상균기본소실,술후경비내경화비두CT관상위가수평위소묘복사,정기수방,기중Ⅰ조80례전유46례,호전30례,치유솔위57.5％,Ⅱ조120례전유78례,호전30례,치유솔위65％,Ⅲ조40례전유32례,호전8례,치유솔위80％,Ⅲ조림상료효현저우우Ⅰ조、Ⅱ조,각조결과비교차이구유통계학의의(P＜0.05).Ⅲ조술후적비강-비두결국측시평분현저우우Ⅰ조、Ⅱ조,각조수술전후적비강-비두결국측시평분차이균구유현저성(P＜0.05).결론 채용비내경하수술치료만성상합두염,료효학절,환자예후이상,이선택쌍경로개창상합두병변청제술치료경능제고치유솔,치득림상추엄사용.
Objective To explore the clinical efficacy and surgical way of nasal endoscopic surgery under different window modes for chronic maxillary sinusitis.Methods Selected 240 patients diagnosed with chronic maxillary sinusitis; and according to different treatment methods,divided them into the inferior meatus fenestration of maxillary sinus treatment group ( group Ⅰ ),the middle nasal meatus fenestration of maxillary sinus treatment group ( Group Ⅱ ),and dual path of maxillary sinus lesion curettage treatment group ( Ⅲ group ).Compared the clinical efficacy and surgical way between these 3 window modes of nasal endoscopic surgery.Results Nasal congestion,runny nose,olfactory decrease,headache and other symptoms almost completely disappeared in all patients.Followed up at regular interval using nasal endoscopy and sinus CT with coronal and horizontal scanning after treatment,46 cases were cured,and 30 cases improved,witha 57.5％ cure rate,among 80 cases of group Ⅰ ; 78 cases cured,and 30 cases improved,with a cure 65％ rate,among 120 cases of group Ⅱ ; 32 cases cured,and 8 cases improved,with a 80％ cure rate,among 40 cases of group Ⅲ.The clinical efficacy was significantly better in group Ⅲ than in groups Ⅰ and Ⅱ ( P＜ 0.05 ).Postoperative nasal cavity and sinuses end test score was significantly better in group Ⅲ than in group Ⅰ and Ⅱ,and was obviously better in all groups before than after the operation ( P＜ 0.05 ).Conclusions Nasal endoscopic surgery for chronic maxillary sinusitis is efficacious,has a good prognosis,and the choice of dual path fenestration of maxillary sinus lesion removal treatment can improve the cure rate and is worth popularizing clinically.
