慢性鼻窦炎鼻内镜手术后近期失访患者的远期疗效评估

发布时间：2018-02-26 08:18

本文关键词： 鼻窦炎随访疗效　出处：《临床耳鼻咽喉头颈外科杂志》2014年02期 　论文类型：期刊论文

【摘要】：目的:探讨慢性鼻窦炎鼻内镜鼻窦手术后3个月内失访患者的远期疗效及影响因素。方法:收集153例鼻内镜鼻窦手术后1年以上且术后3个月内失访患者的临床资料,对其进行追踪调查,评价其远期疗效。分析患者的临床资料,包括:性别、年龄、文化程度、病程、吸烟、饮酒、前期手术史、变应性鼻炎、是否伴有鼻息肉、视觉模拟量表评分、鼻内镜检查评分、CT检查评分、手术医生的内镜手术经验(年限)、术后鼻用糖皮质激素使用、术后鼻腔冲洗等,对结果进行Logistic回归分析。结果:153例患者远期疗效评定,病情完全控制32例(20.9%),病情部分控制74例(48.4%),病情未控制47例(30.7%)。经多因素Logistic回归分析,CRS不伴鼻息肉、不伴变应性鼻炎、无前期手术史、CT评分在5分以下、由内镜手术经验在5年以上的医生手术、术后鼻用糖皮质激素使用超过4周的失访患者的临床疗效优于相应组别的患者,均差异有统计学意义(均P0.01)。结论:慢性鼻窦炎患者鼻内镜手术后应强调随访的重要性,并根据患者的病情制定相应的随访计划,部分病变轻、手术适当的患者可减少或不做术腔处理。
[Abstract]:Objective: to investigate the long-term efficacy and influencing factors of patients with chronic sinusitis after endoscopic sinus surgery (ESS). Methods: the clinical data of 153 patients with chronic sinusitis after endoscopic sinus surgery more than 1 year and within 3 months after endoscopic sinus surgery were collected. The clinical data of the patients were analyzed, including sex, age, education, course of disease, smoking, drinking, early surgical history, allergic rhinitis, and nasal polyps. Visual analogue scale score, nasal endoscopy score, CT score, experience of endoscopic surgery (years of operation, postoperative nasal glucocorticoid use, postoperative nasal cavity irrigation, etc.), The results were analyzed by Logistic regression analysis. Results according to the results of Logistic regression analysis, 32 cases were completely controlled, 74 cases were partially controlled, 47 cases were not controlled by Logistic regression analysis, there were no nasal polyps and no allergic rhinitis by multivariate Logistic regression analysis. The CT score was less than 5. The clinical curative effect of the patients with nasal glucocorticoid use more than 4 weeks after operation was better than that of the patients in the corresponding group by the doctors who had more than 5 years experience in endoscopic surgery and who had been treated with glucocorticoid for more than 4 weeks. Conclusion: the importance of follow-up should be emphasized after endoscopic sinus surgery in patients with chronic sinusitis. Appropriate surgical procedures for patients may be reduced or not treated with surgical lumen.
【作者单位】：华中科技大学附属普爱医院耳鼻咽喉科;武汉大学公共卫生学院;
【分类号】：R765.4

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