慢性鼻-鼻窦炎术后随访对比观察.docVIP

慢性鼻-鼻窦炎术后随访对比观察 　【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 Plt;0.01）。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 Postoperative followup of chronic rhinosinusitis: a comparative observation ［ABSTRACT］ Objective: To evaluate the total response of postoperative endoscopic checkup 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, Plt;0.05). 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； Followup; 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［24］。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Ⅱ型1期2期3期Ⅲ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，鼻内镜随访