功能性鼻内镜鼻窦手术治疗老年慢性鼻-鼻窦炎鼻息肉的安全性评估

目的探讨老年慢性鼻-鼻窦炎鼻息肉患者行功能性鼻内镜鼻窦手术（functional endoscopic sinus surgery，FESS）的安全性。方法回顾性对照性研究，分析中山大学附属第一医院耳鼻咽喉科医院2007年8月至2010年4月拟行FESS手术的老年患者（≥60岁）101名的病例资料，并随机抽取同期行FESS手术的中青年患者（18～59岁）100例作为对照组，比较合并疾病、手术出血量、手术时间和手术并发症的差异，围手术期合并疾病情况。结果101名老年患者中60％合并基础疾病，高于中青年组（19％，P〈0．05），老年组5例经术前评估不能耐受手术，其余96名行FESS手术，手术时间（50minVS60min）、手术出血量（50mLVS50mL）和并发症发生率（1％VS2％）两组间差异无统计学意义（P〉0．05）。并发症：老年组1例，为术后需要输血，中青年组2例，均为纸样板损伤。所有病例围手术期基础疾病无恶化。结论经过仔细的术前评估处理，老年慢性鼻-鼻窦炎鼻息肉行FESS手术的安全性良好。

Safety study of functional endoscopic sinus surgery in aged patients with chronic rhinosinusitis and nasal polyps

Objective To study the safety of functional endoscopic sinus surgery （ FESS ） in aged patients with chronic rhinosinusitis and nasal polyps. Methods From Aug 2007 to April 2010, a retrospective control study of 101 aged patients （≥60 years） and 100 patients （ aged 18 to 59 years） with chronic rhinosinusitis and nasal polyps, who were in hospital and prepare to receive FESS. The differences of operation time, blood loss intro-operation and surgical complications between two groups were compared. Results 60% aged patients combined general diseases, which was higher than the young group （19%, P〈0.05）. After pre-operative evaluation, 5 aged patients were considered could not tolerant FESS, and the other 96 aged patient received FESS. There were no significant statistical differences between operation time （ 50 min vs 60 min）, blood loss intro-operation （50 MI vs 50 mL） and surgical complications rate （1% vs 2%）. One patient in aged group need blood transfusion after surgery and 2 patients in young group suffered from lamina papyracea injury. No deterioration of combined diseases was reported in the perioperative period. Conclusion FESS in aged patients is a safe treatment modality for chronic rhinosinusitis and nasal polyps after careful pre-operative evaluation and management.