892例慢性鼻－鼻窦炎患者内镜鼻窦手术围手术期临床分析

目的 探讨内镜鼻窦手术围手术期处理原则及注意事项。方法 分析892例内镜鼻窦手术患者术后随访及手术1年后治疗效果。 结果 根据慢性鼻－鼻窦炎诊断和治疗指南2008年南昌标准，以手术后1年为近期疗效评估时间，采用Lund-Kennedy评分法进行鼻内镜检查量化评估，892例中治愈759例（82.5%），好转133例（15%）,无效22例（2.5%），均为慢性鼻－鼻窦炎伴有鼻息肉的患者。手术并发症为眶纸板损伤27例，脑脊液鼻漏11例，术后大出血1例，筛顶损伤6例，多数并发症发生于手术后初期。 结论 认真的围手术期治疗、建立术后严格的鼻内镜随访换药制度是防止手术并发症、提高手术疗效的关键。

Clinical analysis on peri-operative medication for endoscopic sinus surgery of 892 cases of chronic rhinosinusitis

Objective To explore the peri-operative treatments and notes of endoscopic sinus surgery. Methods The follow-up results and treatment effects after 1 year of endoscopic sinus surgery were analyzed. Results Based on the chronic rhinosinusitis diagnosis and treatment guidelines of Nanchang 2008, a quantitative assessment with an endoscopic examination was made by Lund-Kennedy Scoring at 1 year after the operation. In 892 cases, 759 cases were cured（82.5%）, 133 cases were improved（15%）, 22 cases were not improved（2.5%）. These patients all had chronic rhinosinusitis with co-morbidity of the nasal polyps. Complications of endoscopic sinus surgery included 27 cases of injury of the lamina papyracea,11 cases of cerebrospinal rhinorrhea, 1 case of hemorrhea after the operation, and 6 cases of injury of the ethmoid roof. Most of these occurred at an early stage after the surgeries. Conclusions Prevention of operational complications and improvement of the effect depends on rigorous peri-operative treatments, follow-up and endoscopic dressing.