慢性鼻窦炎鼻息肉修正性鼻内镜手术49例

目的探讨慢性鼻窦炎鼻息肉修正性手术的方法、疗效和并发症。方法回顾性分析了该科2000年8月￣2004年8月49例慢性鼻窦炎鼻息肉行修正性鼻内镜手术患者,按照微创手术原则,针对每个病例的不同情况采取个性化的处理措施,对其分型、分期、手术疗效及并发症进行总结。结果治愈34例(69.40%),好转10例(20.40%),无效5例(10.20%)。并发症发生率:严重并发症2例(4.080%),轻微并发症10例(20.41%)。结论修正性鼻内镜手术仍应本着微创的原则,对鼻腔及鼻窦各部位采用个性化处理。围手术期治疗也占有十分重要的地位。应高度重视第一次功能性鼻内镜手术及围手术期治疗,从而减少再次或多次手术的机会,减轻病人的痛苦及经济负担。

Revision endoscopic sinus surgery for recurrent chronic sinusitis and nasal polyps in 49 cases

[Objective] To evaluate the effectiveness of revision endoscopic sinus surgery (RESS) for recurrent chronic sinusitis and nasal polyps, according to the basic rules of minimal invasive surgery. [Method] A retrospective analysis was conducted on 49 cases of recurrent chronic sinusitis and nasal polyps during 2000~2004. As in each case, individual treatment were performed according to respective situations. The types and stages of the disease; the effects of the operation and the complications were summarized. [Results] All the patients were followed-up for 6~39 months, 34 of them were cured (69.40%), 10 were improved (20.40%), 5 did not get any improvement(10.20%). The rate of severe complications was 4.08%, and slight complications, 20.41%. [Conclusion] For RESS, it is still of major importance to keep the normal or reversible tissue, under the premises of thoroughly removal of the diseased. The treatments to each area of the nasal and sinus cavity should be individually decided according to the different situations. The proper follow-up treatments, as well as the conduct of medicines topically or systematically pre-and postoperatively also contribute to the good results.