慢性鼻窦炎鼻息肉鼻内镜术后复发原因分析

目的探讨鼻内镜手术治疗慢性鼻窦炎鼻息肉术后复发的原因。方法回顾性分析2007-2008年我院行鼻内镜手术治疗慢性鼻窦炎鼻息肉268例中术后复发26例患者的临床资料。结果复发患者中,临床分型为Ⅱ-Ⅲ型20例,围手术期未进行抗生素、激素治疗4例,术后发生鼻腔黏连16例,术后钩突残留10例,术中鼻中隔偏曲未矫正8例,术中中鼻甲和下鼻甲未处理6例,副鼻窦口及窦内病灶未清除彻底12例,术后未定期进行鼻腔处理和未合理用药14例。约90%的复发患者是多种因素共同引起的。结论慢性鼻窦炎鼻息肉鼻内镜术后复发与其临床分型、围手术期用药、术后鼻腔黏连、钩突的切除、鼻中隔偏曲与中、下鼻甲的处理、副鼻窦口的开放、术后鼻腔定期换药及术后合理用药密切相关。

Causal analysis of recurrent chromic rhinosinusitis and nasal polyps after endoscopic sinus surgery

Objective To explore the causes of recurrent chronic rhinosinusitis and nasal polyps after endoscopic sinus surgery （ESS）. Methods Clinical data were reviewed and analyzed of 26 eases of recurrent chronic rhinosinusitis and nasal polyps chosen from 268 cases undergoing ESS in our hospital from 2007 to 2008. Results In the 26cases ,20 cases clinically fit into type Ⅱ and type Ⅲ,4 cases were caused due to failing to use antibiotics and hormones during pefi-surgery,8 cases by failing to correct the deviation of nasal septum during the surgery,6 cases by failing to treat superior turbine and inferior turbine in the surgery, 16 cases because of adhesion in nasal cavity after the surgery, 10 cases by remains of uneinate process, 12 cases by incomplete removal of focuses in ostiun and accessory nasal sinuses and 14 eases by improper medicament or without regular management of nasal cavity. About 90% of the patients of the recurrent chronic rhinosinusitis and nasal polyps were caused by multifaetors. Conclusion Recurrent chronic rhinosinusitis and nasal polyps are closely related with their clinical type,medicament before the surgery, addesion in nasal cavity after the surgery, removal of uneinate process, deviation of nasal septum, treatment of superior turbine and inferior turbine, opening of accessory nasal sinuses and regular medicament and management after the surgery.