上颌窦引流支架在鼻内窥镜鼻窦手术后的治疗作用

目的探讨上颌窦引流支架在鼻内窥镜鼻窦手术后的治疗作用。方法在经鼻内窥镜鼻窦手术后2～4周,平均3.5周,将上颌窦引流支架放置到上颌窦开口处,定期随访2周、4周、2个月、4个月、6个月,观察临床症状及筛窦腔和上颌窦口开放情况,本组治疗22例(26侧);另随机选择对照组24例(30侧),术后按常规定期随访换药,对比两组治疗效果。结果6个月后,治疗组所有病例临床症状均明显好转,鼻腔清洁,上颌窦口及筛窦腔开放良好,临床好转率100%。对照组鼻塞、流脓涕9侧,同时伴鼻息肉复发3侧,筛窦腔粘连闭锁4侧,上颌窦口狭窄<3mm4侧,闭锁1侧,有2例因再发头痛需行二次手术,临床好转率(21/30)70%。两组疗效相比,经χ2检验P<0.05,差异有显著性。结论鼻窦内窥镜鼻窦手术后安装上颌窦引流支架的治疗作用为①预防上颌窦开口及筛窦腔粘连和再闭锁;②保证筛窦腔和上颌窦开口手术区完好的上皮化;③术后延缓全愈病例明显减少。

Application value of using maxillary stent after endoscopic sinus surgery

Objective To study the application value of using maxillary stent after endoscopic sinus surgery. Methods 2-4 weeks (means 3.5 weeks) after endoscopic sinus surgery, maxillary stent were placed and to observe postoperative symptoms improvement and condition of ethmoid sinus and maxillary sinus orifice by follow-up for 2 week, 4 week, 2 month, 4 month, 6 month respectively. Patients were divided into two groups randomly, the trial group patient 22 (26 side); the control group patient 24 (30 side). Results After 6months, all of the trial group patients' clinical symptoms were improved. In control group, 9 sides nasal obstruction, purulent rhinorrhea, with 3 cases nasal polyps were founded, 3 cases ethmoid sinus adhesion. Conclusion The efforts of using maxillary stent after endoscopic sinus surgery: 1, To prevent maxillary sinus orifice and ethmoid sinus adhesion. 2, To ensure ethmoid sinus and maxillary sinus orifice complete epithelization. 3, To reduce the rate of postoperative delay cure obviously.[