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目的探讨经鼻内窥镜手术治疗鼻窦炎和鼻息肉的疗效量化评价效果。方法收集我院2009年4月至2010年3月共156例经鼻内窥镜手术的慢性鼻窦炎和鼻息肉患者资料,对治疗疗效进行量化评价。结果 156例患者手术过程顺利,术后发生并发症5例,其中眶内血肿2例,术后出血3例,出血量约100～500ml不等,均在术后3d内止血,无其他严重并发症。根据1997年海口会议标准评价:治愈109例,好转29例,无效18例,有效率为88.5%。根据2009年中华医学会耳鼻咽喉头颈外科学会鼻科学组推荐评估,经术后3～12个月复诊评价:(1)鼻塞症状的VAS评分为(2.1±0.3)分,黏性、脓性鼻涕的VAS评分为(1.2±0.2)分,均较术前显著下降(P<0.05)。(2)鼻内镜检查评分3个月、6个月、12个月分别为(2.4±0.3)分、(1.7±0.2)分和(0.8±0.2)分,鼻窦CT扫描量化评分(2.8±0.3)分,均较术前显著下降(P<0.05)。结论鼻内窥镜手术是治疗慢性鼻窦炎、鼻息肉的有效方法,并发症发生率低,采用新的疗效量化评价指标更加准确实用。
Objective To evaluate the curative effect of nasal endoscopic sinus surgery for nasal polyps and nasal polyps. Methods A total of 156 patients with chronic sinusitis and nasal polyps undergoing endoscopic sinus surgery were collected from April 2009 to March 2010 in our hospital to evaluate the curative effect. Results 156 patients underwent a successful operation with 5 postoperative compliations. Among them, 2 had orbital hematoma, 3 had hemorrhage after operation, and the amount of bleeding was about 100 ~ 500ml. Hemostasis occurred within 3 days after operation, and no other serious complications disease. According to the 1997 Haikou meeting standard evaluation: 109 cases were cured, improved in 29 cases, 18 cases were ineffective, the effective rate was 88.5%. According to the 2009 Chinese Medical Association otolaryngology and head and neck surgery nasal science group recommended assessment, after 3 to 12 months of follow-up evaluation: (1) nasal obstruction symptoms VAS score was (2.1 ± 0.3) points, sticky, purulent nasal discharge VAS score of (1.2 ± 0.2) points were significantly lower than those before surgery (P <0.05). (2) The score of nasal endoscopy was (2.4 ± 0.3), (1.7 ± 0.2) and (0.8 ± 0.2) at 3, 6 and 12 months, 0.3), all significantly lower than those before operation (P <0.05). Conclusion Nasal endoscopic surgery is an effective method for the treatment of chronic sinusitis and nasal polyps. The complication rate is low. It is more accurate and practical to adopt the new quantitative evaluation index of curative effect.