鼻内镜手术治疗慢性鼻-鼻窦炎575例疗效分析

目的探讨鼻内镜下鼻窦手术治疗慢性鼻-鼻窦炎（CRS）的疗效。方法对575例CRS患者按照海口标准分型，其中I型204例，Ⅱ型281例，Ⅲ型90例。术前进行围手术期处理，采用鼻内镜手术，术后进行综合治疗，随访6个月以上，根据海口疗效标准进行评估。结果Ⅰ型治愈率为92．6％（189／204），Ⅱ型治愈率为73．0％（205／281），Ⅲ型治愈率为53．3％（48／90），3型之间比较治愈率有统计学意义（P〈0．05）。术后眶纸样板损伤11例，鼻腔粘连76例，术中大出血5例，进行相应处理后全部治愈。结论术前病情评估、准确的临床分型和围手术期及术后综合治疗，是提高治愈率的重要因素。

Therapeutic effect of endoscopic sinus surgery on 5 7 5 patients with chronic rhinosinusitis

Objective To investigate the therapeutic effect of endoscopic sinus surgery （ESS） on chronic rhinosinusitis （CRS）. Methods 575 patients with CRS in this study were grouped into three types based on Haikou standard. 204 cases were Type Ⅰ, 281 and 90 were Tpye Ⅱ and TypeⅢ, respectively. In all cases, proper preoperative treatment was adopted ; ESS was performed followed by a combined postoperative treatment. The therapeutic effect was evaluated base on the Haikou standard more than six months after operation. Results The clinical cure rates of type Ⅰ, Ⅱ and Ⅲ were 92. 6% , 73. 0% and 53. 3% , respectively. The differences of cure rates between different groups were statistically significant （ P 〈 0. 05 ） . As for the surgical complications, injury of papyraceous lamina, severe operative bleeding and nasal adhesion occurred in 11 cases, 76 cases and 5 eases, respectively. All complications were treated and cared with proper treatment. Conclusion Precise preoperative assessment of the state of CRS and adequate preoperative and postoperative treatment are essential to increase the cure rate of ESS on CRS.