鼻内镜修正性手术联合中鼻甲切除治疗难治性鼻-鼻窦炎患者疗效及对围术期指标和预后的影响

doi:10.3969/j.issn.1006-6233.2023.07.014

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Abstract Objective: To investigate the effects of revised endoscopic nasal sinus surgery combined with middle turbinectomy in the treatment of patients with refractory rhinosinusitis and the influence on perioperative condition and the prognosis. Methods: A total of 91 patients with refractory rhinosinusitis were admitted to the hospital from January 2019 to January 2022.They were divided into the control group (n=45) and the observation group (n=46) by random number table method.The control group underwent conventional endoscopic open surgery,while the observation group underwent revised endoscopic sinus surgery combined with middle turbinectomy.Surgical effects of the 2 groups were compared.T & T olfactometry was used to assess changes in olfactory function before and after surgery.The Visual Analogue Scale (VAS) was used to assess changes in subjective symptoms such as nasal congestion,nasal secretions,nasal discharge,head and face swelling pain,hyposmia,and general malaise before and after surgery.The Lund-Kennedy scoring system was used to evaluate changes in objective condition (polyps,edema,scars,scabs,rhinorrhea,etc.),and the Sino-Nasal Outcome Test-20 (SNOT-20) was used to evaluate quality of life.The occurrence of surgical complications was recorded,and 1-year recurrence rate was counted. Results: The curative effect classification and olfactory function classification at 6 months after surgery in the observation group were better than those in the control group (P<0.05).Compared with the control group,the observation group had lower VAS scores for nasal congestion,nasal secretions,nasal discharge,head and face swelling pain,hyposmia and general malaise,lower scores for polyps,edema,scars and scabs,and lower SNOT-20 score at 6 months after surgery (all P<0.05).The incidence rates of nasal adhesion,periorbital bruising,intraocular rectus injury and follow-up recurrence rate in the observation group were slightly lower than those in the control group,but the differences were not statistically significant (P>0.05). Conclusion: Revised endoscopic sinus surgery combined with middle turbinectomy is effective in the treatment of patients with refractory rhinosinusitis,which can improve olfactory function,subjective and objective symptoms as well as quality of life,and reduce the risk of recurrence.

Key words： Sinusitis Nasal endoscope Revised surgery Middle turbinectomy Olfactory sensation

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	CHEN Xingrong
	XIE Yunping
	ZHANG Zhibin

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CHEN Xingrong,XIE Yunping,ZHANG Zhibin. Efficacy of Revised Endoscopic Sinus Surgery Combined with Middle Turbinectomy in the Treatment of Patients with Refractory Rhinosinusitis and the Influence on Perioperative Indicators and the Prognosis[J]. HeBei Med, 2023, 29(7): 1130-1136.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.07.014 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I7/1130

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