鼻内镜手术治疗慢性鼻窦炎后症状无缓解的处理与相关因素分析

目的探讨慢性鼻窦炎鼻内镜手术后症状无缓解的相关因素及治疗策略。方法回顾性分析我科2007年7月~2014年5月收治的179例已接受鼻内镜手术治疗但临床症状无缓解的患者的临床资料,分析其无缓解的原因及治疗策略。结果所有无缓解病例均行修正性鼻内镜手术,治愈159例,有效20例。经多因素分析,慢性鼻窦炎发病原因、医生的学历、职称、鼻内合并症、术中和术后情况是影响慢性鼻窦炎鼻内镜手术后症状无缓解的相关因素。结论手术技巧不熟练,解剖知识欠缺,鼻窦炎发生的原因、鼻内合并症、术中和术后情况是导致慢性鼻窦炎鼻内镜手术失败的根本原因。

Clinical Survey of Symptoms Non-improvement after Endoscopic Surgery for Chronic Sinusitis

Objective To study the causes of symptoms non-improvement after endoscopic surgery for chronic sinusitis. Method 179 cases with symptoms non-improvement after endoscopic surgery for chronic sinusitis from July 2007 to May 2014 were retrospectively analyzed of the causes and treatment strategies. Results All cases with symptoms non-improvement after endoscopic surgery for chronic si- nusitis were treated by revisionary endoscopic surgery. 159 cases were cured and 20 cases improved after surgery. By multi-factor analysis, it showed that the doctors＇medicine education, work experience, and the patients＂ nasal complications, intraoperative and postoperative situations were the mainly related factors. Conclusion It is the fundamental causes for the nasal endoscopic surgery failure of the doctors＂ unskilled operations and incomplete anatomical knowledge, and the patients＂ chronic sinusitis causes, intraoperative and postoperative suitations and complications.