鼻内镜治疗鼻窦炎患者的疗效观察

目的观察鼻内镜手术治疗鼻窦炎的疗效,探讨不同感染因素对鼻窦炎预后的影响作用。方法 2004年1月至2010年12月开展鼻内镜手术1015台,患者经局麻采用Messerklinger术式,并同时纠正鼻腔结构异常。有698例(68.8%)患者被确诊为细菌感染、152例(15.0%)为真菌感染,其余165例(16.3%)未发现明确致病菌。术后随访1~2年,生理盐水冲洗术腔,根据海口标准(1997年)判断疗效。结果治愈817例、好转153例、无效45例,总有效率为95.6%。并发症15例,发生率为1.5%。细菌、真菌和不明确致病菌感染病例中无效病例分别有30例(4.3%)、8例(5.3%)、7例(4.2%),三组有效率无显着差异。结论鼻内镜手术治疗慢性鼻-鼻窦炎效果良好,不同感染情况下经术腔定期清理未使用相应药物即可获得相似的有效率。

The Curative Effect of Endoscopic Sinus Surgery in Sinusitis Patients

Objective To study the curative effect of endoscopic sinus surgery （ESS） in sinusitis patients and discuss the influence of infectious factors to the prognosis of sinusitis. Methods Endoscopic sinus surgery was operated in 1015 patients recruited from Jan 2004 to Dec 2010. bacteria and fungus were found in 698 （68.8%） and 152 （15.0%） patients, respectively. The operative cavity was rinsed with saline solution during 1-2 years follow-up. Judge the efficacy according to The Guideline of Haikou （1997） . Results 817 patients were cured, 153 were improved and 45 were recurred, that makes the overall effective rate is 95.6%. The complication rate was 1.5% （15 patients） . The ineffective rate are 4.3% （30 patients） , 5.3% （8） and 4.2% （7） in bacterium, fungal and no clear germs patients, respectively. The effective rates between the three groups have no significant difference. Conclusion ESS is efficacy in the treatment of chronic sinusitis, the effective rates in patients infected with different pathogenic factors after regular clean the cavity and no chemotherapy are similar.