【摘要】 目的分析鼻内镜联合下鼻道开窗双径路治疗上颌窦难治性病变的效果。方法回顾性分析2013年1月~2015年5月四川省宜宾市第二人民医院收治的102例(115侧)上颌窦难治性病变患者的临床资料,患者术前均行鼻窦冠状位及水平位CT、鼻内镜检查,且经术后病理检查明确诊断。根据手术方式不同,将患者分为观察组和对照组。观察组52例患者采用鼻内镜联合下鼻道开窗双径路手术,对照组50例采用传统的单纯鼻内镜手术治疗。术后随访观察并比较两种术式的治疗效果及预后情况。结果两组患者性别、年龄、疾病类型比较,差异均无统计学意义(P>0.05)。观察组总有效率为100.0%,对照组总有效率为84.0%,差异有统计学意义(P<0.05)。所有患者术后均随访5个月~1年,观察组患者术后复查CT,未见原发部位病变复发,窦腔黏膜均未出现纤维化,术腔清理干净、无肿胀及脓性分泌物,上颌窦均自然开口,且通畅,创面愈合良好;对照组患者术后复查CT,5例患者出现病变在原手术部位复发,窦腔黏膜出现纤维化表现。结论鼻内镜联合下鼻道开窗双径路治疗上颌窦难治性病变可彻底清除病变,复发率低,疗效肯定,值得临床推广应用。更多还原

【Abstract】 Objective To analyze effect of nasal endoscope combine with double path fenestration operation of inferior meatus in the treatment of maxillary sinus refractory disease.Methods Clinical data of 102 cases(115 sides) of patients with the refractory maxillary sinus lesions treated in the Second People’s Hospital of Yibin City in Sichuan Province from January 2013 to May 2015 were retrospectively analyzed,all patients were given the detection of preoperative CT at the level of coronary sinus and nasal endoscopic examination,and were diagnosed by the postoperative pathologic.According to different way of operation,patients were divided into observation group and control group.52 cases of observation group were treated by nasal endoscope combine with double path fenestration operation of inferior meatus,50 cases of control group were given traditional pure nasal endoscopic surgery.Postoperative followed up on a regular basis,the therapeutic effect and prognosis of two kinds of operative methods were observed and compared.Results There were no statistically significant differences in gender,average age,disease types of patients between two groups(P > 0.05).Total effective rate in observation group was 100.0%,total effective rate in control group was 84.0%,the difference was statistically significant(P < 0.05).All patients were followed up for 5 months to 1 year postoperatively,patients of two groups were given postoperative CT checking again,patients of observation group had no recurrence in primary lesions,sinus mucosa had not been appeared fibrosis,cavity clean,no swelling and purulent secretion,maxillary sinus were natural openings,and unobstructed,the wound healed well.In control group,5 cases with pathological changes in original surgical site,sinus mucosa appeared fibrosis change.Conclusion Nasal endoscope combine with double path fenestration operation of inferior meatus in the treatment of maxillary sinus refractory disease can eradicate refractory maxillary sinus disease,recurrence rate is low,curative effect is definite,it is worthy of clinical promotion and application.更多还原