慢性鼻-鼻窦炎术后随访的对比观察.docVIP

慢性鼻-鼻窦炎术后随访的对比观察 【摘要】 通过对比观察慢性鼻-鼻窦炎鼻内镜术后两种随访结果，探讨鼻内镜随访对慢性鼻-鼻窦炎总体疗效的 影响 。 方法 ：同期接受鼻内镜手术的各类慢性鼻-鼻窦炎123例，依据随访完成情况的不同，分为A、B两组，对比 分析 其转归情况。结果：A组56例，6个月痊愈31例、好转24例、无效1例；12个月痊愈44例、好转12例、无效0例。B组67例，6个月痊愈14例、好转43例、无效10例；12个月痊愈24例、好转42例、无效1例。两组病情转归情况差异有统计学意义（χ2=18.387 P0.01）。结论：鼻内镜术后随访情况的不同可以直接影响到综合 治疗 的合理实施及慢性鼻-鼻窦炎的总体疗效。 【关键词】 内窥镜 鼻窦炎 随访 治疗结果 A Postoperative followup of chronic rhinosinusitis: a comparative observation ［ABSTRACT］ Objective: To evaluate the total response of postoperative endoscopic checkup in chronic rhinosinustitis. Method: The response rates of two groups with chronic rhinosinusitis after the same endoscopic sinus surgery were compared and analyzed according to different followup methods. Results: In group A, 31 cases were cured, 24 were improved and 1 had no response during a sixmonth followup; 44 cases were cured and 42 had a response during a twelvemonth followup. In group B, 14 cases were cured, 43 were improved and 10 had no response during a sixmonth followup; 24 were cured, 42 were improved and 1 had no response during a twelvemonth followup. The response rate between group A and B was of significant difference (χ2=18.387, P0.05). Conclusion: Postoperative endoscopic checkup is the most important factor for increasing the total response of endoscopic sinus surgery for chronic rhinosinusitis. ［KEY WORDS］ Endoscopy; Sinusitis； Followup; Treatment outcome 随着鼻内镜手术的广泛开展以及操作水平的不断提高，手术前后综合治疗的完善与否，已经成为制约慢性鼻-鼻窦炎总体疗效的重要因素。但是，综合治疗的实施，不仅需要术前对慢性鼻-鼻窦炎的具体类型及病变程度有一个正确的判断，更为重要的是要依据术后的具体病情变化和恢复情况，及时调整综合治疗方案，而这一切最为重要的依据，来源于鼻内镜下的随访观察。 1997年制订的“海口标准”只是对鼻内镜术后随访提出了一个“近期随访不少于6个月，远期随访1年以上”［1］的总体时间要求，却没有对随访设备、观察 内容 、间隔时间、判定标准、处理原则等提出具体要求。 为此，1997年始，我们与 计算 机专业人员合作，自主研发了一套专门用于慢性鼻-鼻窦炎术后随访的多媒体鼻内镜随访系统［24］。2002年经再次改进慢性鼻-鼻窦炎术后随访的对比观察组别3期型1期2期3期型合计141810B组191912合计3315372017123 1.2 随访设备 1.2.1 多媒体鼻内镜随访系统 包括（1） 内窥镜冷光源系统：德国Explorent 0°，70°鼻内镜，300?W氙灯冷光源; (2) 电视监视系统：3CCD摄像系统，索尼监视器; (3) 多媒体图像采集系统：包含数据库管理的所有相关文字性病历资料，CT影像，鼻内镜图像，图像实时对比等功能［4］。 1.2.2 其他设备与器械 耳鼻喉科综合治疗台，鼻内镜