修正性鼻内镜鼻窦手术与初次鼻内镜鼻窦手术治疗慢性鼻-鼻窦炎疗效比较

发布时间：2018-08-07 14:54

【摘要】：目的通过比较修正性鼻内镜鼻窦手术(RESS)与初次鼻内镜鼻窦手术(PESS)后的主客观疗效,了解既往鼻窦手术史是否会影响RESS的术后疗效,RESS是否能取得与PESS术同样的临床疗效。方法采用视觉模拟量表(VAS)、鼻腔鼻窦结局测试20条(SNOT-20)、医学结局研究简表36项健康调查(SF-36)、慢性鼻-鼻窦炎(CRS)诊断和治疗指南(2012年,昆明)以及Lund and Kennedy内镜评分系统对45例RESS患者和59例初次鼻内镜鼻窦手术患者进行主客观疗效评价,并将结果进行比较。结果两组患者VAS评分、SNOT-20评分和SF-36评分术后均得到显著改善(P0.05),两组患者手术有效率、手术前后生活质量评分和改善情况以及Lund and Kennedy内镜评分差异均无统计学意义(P0.05)。结论在正确掌握适应证及充分合理的围手术期综合治疗处理前提下,结合熟练正确的手术操作可消除既往鼻部手术史对RESS疗效的不良影响,RESS能够取得与PESS相似的主客观疗效。
[Abstract]:Objective to compare the subjective and objective effects of modified endoscopic sinus surgery (RESS) with primary endoscopic sinus surgery (PESS) in order to find out whether the past history of sinus surgery will affect the curative effect of RESS. Methods A visual analogue scale (VAS),) was used to measure 20 nasal and paranasal sinus outcomes (SNOT-20), 36 health surveys (SF-36), and (CRS) guidelines for the diagnosis and treatment of chronic rhinosinusitis (2012). Kunming) and Lund and Kennedy endoscopic scoring system were used to evaluate the subjective and objective efficacy of 45 patients with RESS and 59 patients with primary nasal endoscopic sinus surgery, and the results were compared. Results the VAS score, SNOT-20 score and SF-36 score of the two groups were significantly improved after operation (P0.05). There was no significant difference between the two groups in the effective rate, quality of life score and improvement before and after operation and Lund and Kennedy endoscopic score (P0.05). Conclusion under the premise of correct indication and reasonable comprehensive treatment in perioperative period, combined with skilled and correct operation, the adverse effect of previous nasal operation on the curative effect of RESS can be eliminated. Tess can obtain subjective and objective effect similar to that of PESS.
【作者单位】：上海交通大学医学院附属瑞金医院耳鼻咽喉科;
【分类号】：R765.9

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