摘要
目的比较三种术式治疗慢性鼻-鼻窦炎(CRS)的临床疗效。方法回顾性分析2015年6月至2017年6月在重庆市大足区人民医院住院的120例CRS患者的临床资料,根据手术方式不同分为球囊扩张组、鼻窦开放组和上颌窦根治组,分别接受鼻窦球囊扩张术、鼻内镜下鼻窦开放术和上颌窦根治术,各40例。比较三组患者的手术时间、术中出血量、手术费用,以及治疗前后视觉模拟量表(VAS)评分、炎症指标[高敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF)α、白细胞介素(IL) 2]水平和汉化版鼻腔鼻窦结局测试22条(SNOT-22)量表评分。结果鼻窦开放组和上颌窦根治组手术时间长于球囊扩张组[(40. 6±9. 4) min、(62. 8±10. 2) min比(21. 5±6. 8) min](P <0. 01),术中出血量大于球囊扩张组[(39. 5±6. 3) mL、(58. 5±9. 3) mL比(13. 4±5. 9) mL](P <0. 01),手术费用低于球囊扩张组[(1 450±545)元、(1 020+320)元比(2 250+635)元](P <0. 01)。治疗后,鼻窦开放组和上颌窦根治组鼻塞、黏脓性鼻涕、头痛VAS评分高于球囊扩张组(P <0. 05)。治疗后,鼻窦开放组和上颌窦根治组hs-CRP、TNF-α、IL-2水平高于球囊扩张组(P <0. 05)。治疗后,鼻窦开放组和上颌窦根治组SNOT-22评分高于球囊扩张组[(15. 8±6. 9)分、(19. 4±7. 9)分比(9. 7±5. 3)分](P <0. 01)。结论鼻窦球囊扩张术治疗CRS的临床疗效优于鼻内镜下鼻窦开放术和上颌窦根治术。
Objective To compare the clinical effectiveness of three surgical treatment options for chronic rhinosinusitis(CRS).Methods The clinical data of 120 CRS patients hospitalized in Chongqing Dazu People′s Hospital from Jun.2015 to Jun.2017 were retrospectively analyzed.According to the operation methods,they were divided into a balloon dilatation group,a sinus opening group and a maxillary sinus radical operation group,and received balloon dilatation,endoscopic sinus opening and maxillary sinus radical operation respectively,40 cases each.The operation time,intraoperative bleeding volume,operation cost,visual analogue scale(VAS)score,inflammation index[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor(TNF)α,interleukin(IL)-2]level and Chinese nasal-sinus outcome test-22(SNOT-22)score were compared among the three groups before and after treatment.Results The operation time of the sinus opening group and the maxillary sinus radical operation group was longer than that of the balloon dilatation group[(40.6±9.4)min,(62.8±10.2)min vs(21.5±6.8)min](P<0.01),the amount of bleeding during the operation was greater than that of the balloon dilatation group[(39.5±6.3)mL,(58.5±9.3)mL vs(13.4±5.9)mL](P<0.01),and the operation cost was lower than that of the balloon dilatation group[(1 450±545)yuan,(1 020±320)yuan vs(2 250±635)yuan](P<0.01).After treatment,VAS scores of nasal obstruction,mucopurulent nose and headache in the sinus opening group and maxillary sinus radical treatment group were higher than those in the balloon dilatation group(P<0.05).After treatment,the levels of hs-CRP,TNF-αand IL-2 in the sinus opening group and maxillary sinus radical group were higher than those in the balloon dilatation group(P<0.05).After treatment,the SNOT-22 score in the sinus opening group and the maxillary sinus radical group was higher than that in the balloon dilation group[(15.8±6.9)score,(19.4±7.9)score vs(9.7±5.3)score](P<0.01).Conclusion Balloon dilation has a better clinical effectiveness in comparison with endoscopic sinus opening surgery and radical maxillary sinusectomy to treat CRS.
作者
龙表利
刘勇
张颖
林刚
陈美均
LONG Biaoli;LIU Yong;ZHANG Ying;LIN Gang;CHEN Meijun(Department of ENT,Chongqing Dazu District People′s Hospital,Chongqing 402360,China)
出处
《医学综述》
2018年第24期4974-4978,共5页
Medical Recapitulate
关键词
慢性鼻-鼻窦炎
球囊扩张术
内镜鼻窦开放术
上颌窦根治术
Chronic rhinosinusitis
Balloon dilation
Endoscopic sinus opening surgery
Maxillary sinus radical operation
