功能性内窥镜鼻窦手术切除和保留中鼻甲对疗效的影响

目的 探讨慢性鼻窦炎、鼻息肉内窥镜鼻窦手术中切除或保留中鼻甲对手术疗效的影响。方法 对161例（282侧）作功能性内窥镜鼻窦手术病人进行术后随访，并行内窥镜复查，将中鼻甲切除组75例（139侧）和保留组86例（143侧）的随访结果进行比较。结果 两组手术总有效率：切除组为65例（86.7%）；保留组为70例（81.4%），两组比较差异无显著性（P＞0.05）；而息肉复发率两组分别为20.86%和31.47%（P＜0.05）；中鼻甲粘连分别为5.76%和23.08%（P＜0.01），以上两项两组间比较差异均有显著性。筛窦术腔闭塞率分别为15.11%和18.18%（P＞0.05）；人组病人无萎缩性鼻炎、鳞状上皮化以及鼻中隔鼻甲形态。结论 对多发性鼻窦炎和鼻息肉及中鼻甲息变严重，且与正常粘膜无明显界阶的病人进行功能性内窥镜鼻窦手术时，适当切除中鼻甲可减少息肉复发和中鼻甲粘连，但对症状改善与中鼻甲保留组之间差异无显著性。

Comparison of affect of functional endonasal sinus surgery with and without partial middle turbinate resection

Objective To investigate the affect of Functional Eendoscope Sinus Surgery(FESS) with and without partial middle turbinate resection on effect of surgery. Methods All 161 patients (282 sides) who underwent FESS were followed up and the results were compared between both groups. Results There was no significant difference of general effective rate between both groups. But the rate of the polips recurence was 20.86% in resection group and 31.47% in preservation group(p<0.05);the rate of the middle turbinate adhesion was 5.76% and 23.08% (p<0.01), the rate of the closure of the ethmoid sinuses was 15.11% and 18.18%( p<0.05) respectively. Conclusion Performming FESS on the patients with multiple sinusitis and polips, severe polypoid middle turbinate to resect moderately middle turbinate may reduce the rate of the recurrence of the polyps and the rate of the adhesion, but there is no significant difference in improvement of the symptoms between two groups.