额筛开放鼻内镜手术在难治性鼻窦炎患者中的疗效分析

doi:10.3760/cma.j.cn441417-20250224-16016

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (16): 2720-2724.DOI: 10.3760/cma.j.cn441417-20250224-16016

额筛开放鼻内镜手术在难治性鼻窦炎患者中的疗效分析

杨双元¹ 杨江东¹ 高旭栋² 钟伟³

¹南昌大学第一附属医院高新医院耳鼻咽喉科，南昌 330029；²陕西省人民医院耳鼻咽喉科，西安 710068；³南昌大学第一附属医院耳鼻咽喉科，南昌330006

收稿日期:2025-02-24 出版日期:2025-08-15 发布日期:2025-08-28
通讯作者: 钟伟，Email：18701586796@163.com
基金资助:
陕西省重点研发计划（S2024-YF-YBSF-1084）

Efficacy of transfrontal-ethmoidal open endoscopic sinus surgery in treatment of patients with refractory rhinosinusitis

Yang Shuangyuan¹, Yang Jiangdong¹, Gao Xudong², Zhong Wei³

¹Department of Otolaryngology, Gaoxin Branch, The First Affiliated Hospital of Nanchang University, Nanchang 330029, China; ²Department of Otolaryngology, Shannxi Provincial People's Hospital, Xi'an 710068, China; ³Department of Otolaryngology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, China

Received:2025-02-24 Online:2025-08-15 Published:2025-08-28
Contact: Zhong Wei, Email: 18701586796@163.com
Supported by:
Key Plan of Research and Development in Shannxi (S2024-YF-YBSF-1084)

摘要/Abstract

摘要：

目的　比较功能性鼻内镜手术和以额筛区域为核心的全组鼻窦开放鼻内镜手术对难治性鼻窦炎患者的术后疗效。方法　采用回顾性分析，选取2021年12月至2024年7月南昌大学第一附属医院高新医院收治的43例难治性鼻窦炎患者作为研究对象，其中男27例，女16例，年龄21～68岁。试验组23例（53.4%），采用以额筛区域为核心的全组鼻窦开放鼻内镜手术；对照组20例（46.6%），采用功能性鼻内镜手术。统计两组患者术前、术后半年内（术后2周、1个月、3个月、6个月）的主客观评分，即中文版鼻腔鼻窦结局测试22条（SNOT-22）、鼻内镜Lund-Kennedy及视觉模拟量表（VAS）评分。采用χ²检验、t检验、秩和检验进行统计学分析，并总结不同手术方式术后患者的主、客观指标差异。结果　两组患者术后SNOT-22、鼻内镜Lund-Kennedy及VAS评分均低于术前，差异均有统计学意义（均P<0.05）。两组术后2周、1个月、3个月评分比较，差异均无统计学意义（均P>0.05）；术后6个月，试验组SNOT-22为（3.26±4.08）分、Lund-Kennedy为0（0，1.00）分、VAS为（1.13±2.53）分，均低于对照组［（9.95±8.12）分、3.00（2.25，4.00）分、（5.15±4.43）分］，差异均有统计学意义（均P<0.05）。结论　与功能性鼻内镜相比，对于远期术后疗效以额筛区域为核心的全组鼻窦开放鼻内镜手术更能有效缓解患者的鼻窦炎症反应，改善主观症状，提高术后主客观评分。

关键词:

鼻息肉, 难治性鼻窦炎, 嗜酸性粒细胞, 功能性鼻内镜手术, 额筛区域, 全组鼻窦开放术

Abstract:

Objective　To compare the postoperative efficacies of functional endoscopic sinus surgery and whole group open endoscopic sinus surgery centered on the frontal and ethmoid regions for patients with refractory sinusitis. Methods　Forty-three patients with refractory sinusitis treated at Gaoxin Branch, the First Affiliated Hospital of Nanchang University from December 2021 to July 2024 were selected as the study objects, including 27 males and 16 females. They were 21-68 years old. There were 23 cases (53.4%) in the experimental group and 20 cases (46.6%) in the control group. The control group took functional endoscopic sinus surgery, and the experimental group whole group open endoscopic sinus surgery centered on the frontal and ethmoid regions. The scores of Sino-nasal Outcome Test-22 (SNOT-22), nasal endoscopic Lund-Kennedy, and Visual Analogue Scale (VAS) before and 2 weeks, 1 month, 3 months, and 6 months after the surgery were compared between the two groups. χ² test, t test, and rank sum test were used for the statistical analysis. Results　The scores of SNOT-22, nasal endoscopic Lund-Kennedy, and VAS were lower after than before the surgery in both groups, with statistical differences (all P<0.05). There were no statistical differences in the scores of SNOT-22, nasal endoscopic Lund-Kennedy, and VAS 2 weeks, 1 month, and 3 months after the surgery between the two groups (all P>0.05). Six months after the surgery, the scores of SNOT-22, nasal endoscopic Lund-Kennedy, and VAS in the experimental group were lower than those in the control group [3.26±4.08 vs. 9.95±8.12, 0 (0, 1.00) vs. 3.00 (2.25, 4.00), and 1.13±2.53 vs. 5.15±4.43], with statistical differences (all P<0.05). Conclusions　Compared with functional endoscopic sinus surgery, whole group open endoscopic sinus surgery centered on the frontal and ethmoid regions for patients with refractory sinusitis is more effective in relieving their sinus inflammation, improving their subjective symptoms, and increasing the postoperative subjective and objective scores.

Key words:

Nasal polyps, Refractory sinusitis, Eosinophil, Functional endoscopic sinus surgery, Frontal and ethmoid regions, Whole group open endoscopic sinus surgery

杨双元杨江东高旭栋钟伟.

额筛开放鼻内镜手术在难治性鼻窦炎患者中的疗效分析 [J]. 国际医药卫生导报, 2025, 31(16): 2720-2724.

Yang Shuangyuan, Yang Jiangdong, Gao Xudong, Zhong Wei.

Efficacy of transfrontal-ethmoidal open endoscopic sinus surgery in treatment of patients with refractory rhinosinusitis [J]. International Medicine and Health Guidance News, 2025, 31(16): 2720-2724.

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额筛开放鼻内镜手术在难治性鼻窦炎患者中的疗效分析

Efficacy of transfrontal-ethmoidal open endoscopic sinus surgery in treatment of patients with refractory rhinosinusitis

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