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P<0.01)。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。
Objective：To investigate the prospective efficacy of chronic sinusitis lost to short-term follow up after nasal endoscopic surgery and the influential factors. Method： Prospective efficacy of 153 chronic sinusitis （CRS） was evaluated . All cases were treated by nasal endoscopic surgery at least I year ago but lost to follow up within 3 months after surgery. The clinical data of 153 patients were analyzed, including gender, age, edueational level, course of the disease, smoking and drinking history, early surgery history, allergic rhinitis（AR） history, nasal polyps, visual analogue scale（VAS）score, nasal endoscopy score, CT examination score, the endoscopic ex perience of surgeons, medication of intranasal glucocorticoid and nasal irrigation after surgery. Multifactor logistic regression analysis were used to analyze the data. Result：Among 153 patient, the symptoms of 32 cases（20.9 ~ ） were completely controled,while those of 74 eases（48.4%） were partially controled, and the symptoms of 47 eases （30. 7%）were not controlled. The curative effect were better for CRS without nasal polyps, AR or early surgery history, with CT examination score^5, operated by surgeons with experience of endoscopy surgery for more than 5 years, and treated with intranasal glucocorticoid for more than 4 weeks after surgery. Conclusion： Postsurgery follow-up should be paid more attention to in treatment of CRS. Plans of follow up should be adjusted to patient＇s condition. Treatment of postoperative sinus cavity should be minimized when the lesion is slight and operated properly.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2014年第2期79-81,共3页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
鼻窦炎
随访
疗效
nasal sinusitis follow up curative effect
