鼻内镜手术治疗慢性鼻窦炎鼻息肉200例临床探讨(1)
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【摘要】 目的 探讨鼻内镜手术治疗鼻窦炎鼻息肉的临床疗效。方法 选择本院2005年5月至2009年5月慢性鼻窦炎鼻息肉患者200例,以上患者均行鼻内镜手术。治疗后根据疗效评定标准,评定本组患者的临床治疗效果。结果 在本组患者中Ⅰ型36例中,治愈34例,好转2例,总有效率为100%;Ⅱ型74例患者中,治愈66例,好转8例,总有效率为100%;Ⅲ型19例患者中,治愈13例,好转4例,无效2例,总有效率为89.8%。本组200例患者中,治愈184例,好转14例,无效2例,本组患者总有效率为99.0%。结论 鼻内镜手术治疗慢性鼻窦炎鼻息肉临床疗效显著,其治疗效果与慢性鼻窦炎临床分型分期有一定关系。
【关键词】 鼻窦炎;鼻息肉;鼻内镜
Analysis of clinical efficacy of 200 cases with chronic sinusitis and nasal polyps treated by endoscopic sinus surgery
WANG Ji-wen,HUANG Yan-bing,WANG Lu-lin.The People’s Hospital of Shanxi province,Lucheng city,Lucheng 047500,China
【Abstract】 Objective To explore the clinical efficacy of endoscopic sinus surgery on chronic sinusitis and nasal polyps.Methods 200 cases with chronic sinusitis and nasal polyps were selected from May,2005 to
May,2009.all the cases were performed by endoscopic sinus surgery.the clinical efficacy of all the caseswas evaluated according to the clinical efficacy standard after treatment.Results All the cases in the group,in 36cases of Ⅰtype,34cases were cured,4 cases were improved,the total effective rate was 100%;in 74 cases of Ⅱtype,66cases were cured,8cases were improved,the total effective rate was 100%;in 19 cases of Ⅲtype ,13cases were cured,4 cases were improved,2 cases were failure,the total effective rate was 89.8%;in 200cases,184cases were cured,14cases were improved,2 cases were failure,the total effective rate was99.0%.Conclusion Endoscopic sinus surgery on chronic sinusitis and nasal polyps has significant clinical efficacy,and the clinical efficacy relates with the typing and staging of chronic sinusitis and nasal polyps.
【Key words】 Sinusitis;Nasal polyps;Endoscopic sinus surgery
慢性鼻窦炎和鼻息肉是临床常见病、多发病,据统计,鼻窦炎全球发病率为5%,而鼻息肉发病率占总人口的1%～4%。其病因多样,主要为慢性感染、变态反应、鼻内解剖异常、黏膜纤毛结构和功能障碍等。对保守治疗无效的慢性鼻窦炎、鼻息肉患者目前采用鼻内镜手术治疗。本文选择本院慢性鼻窦炎鼻息肉患者200例,均采用鼻内镜手术治疗,观察其疗效,现报告如下。
1 资料和方法
1.1 一般资料 选择本院2005年5月至2009年5月慢性鼻窦炎鼻息肉患者200例,其中男131例,女69例,年龄15～67岁,平均(41.2±15.6)岁,病程2～16年,平均(4.6±3.7)年。以上患者均有不同程度的鼻塞、流涕、头痛以及嗅觉减退等症状。根据中华医学会耳鼻喉分会1997年会议制定分型分期标准[1]:在本组患者中Ⅰ型36例,其中1期11例,2期20例,3期5例;Ⅱ型74例,其中1期13例,2期36例,3期25例;Ⅲ型19例。
1.2 治疗方法 本组患者均行鼻内镜手术。采用杭州光典医疗器械有限公司的鼻内镜系统和上海晶杰医用手术吸引切割器系统。本组患者均住院治疗。术前应用抗生素治疗3 d。采用鼻腔黏膜表面局麻,根据MESSKLINGER基本术式由前向后进行手术,息肉钳切除息肉,暴露中鼻道,对多发性息肉者使用动力系统切割钻清除息肉,对有鼻中隔偏曲者,行鼻中隔黏膜下切除术,中鼻甲肥大、外翻、息肉样变或泡样中甲者,进行中鼻甲整形 ......
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