III型鼻窦炎鼻息肉临床分期探讨以及各期手术疗效分析

目的探讨不同病变程度的III型鼻窦炎鼻息肉内窥镜鼻窦手术的疗效和并发症.方法将随访6～18个月的104例(208侧)III型鼻窦炎鼻息肉依据病史、解剖结构、病变程度在临床上分为 3期,并对各期手术临床疗效、并发症进行比较分析.结果 1、2、3期临床总有效率分别为93.06%、82.89% 和70.00% ;并发症发生率分别为5.56%、14.47% 和 25 .00 %.结论 III型患者的解剖学改变(窦口鼻道复合体的完整性)及病变程度(肉芽增生及筛窦骨质增生)决定了手术的难度、风险及疗效,也应列为临床分期的客观依据.

Influence of clinical staging of Type III sinusitis on the operative effectiveness

Objective To explore the influences of different degree of pathological changes in chronic polypous sinusitis patients on the effectiveness of endoscopic sinus surgery Method According to history, anatomic sructures and severity of lesions,104 cases (208 sides) of Type III sinusitis were divided into 3 stages Rates of clinical effectiveness and complications were compard and analyzed Results The total effective rates were 93 06%,82 89% and 70 00% and the rates of complications were 5 56%?14 47% and 25 00% in stages 1, 2, 3 respectively Conclusion The effective rates, difficulties and risks of operation depend upon the anatomic variations (integration of ostiomeatal complex) and the degree of lesions (augmentation of granulation and osseous hypertrophy of ethmoid bone ) All these should be listed as objective bases in classifying stages of patients which will play a directional role in clinical work