鼻窦炎鼻内镜鼻窦手术前后的黏膜形态变化及相关性分析.docVIP

精品论文 参考文献 鼻窦炎鼻内镜鼻窦手术前后的黏膜形态变化及相关性分析 郑茜玲 赵玉祥 刘涛 [摘 要]目的：对患有鼻窦炎（AS）患者经鼻功能内镜手术（FESS）前后黏膜形态变化情况进行观察并分析影响手术疗效的几个相关性因素。方法：以2013年3月~2014年3月间98名于我院行FESS术的AS患者为研究对象，分阶段观察术后患者的鼻腔黏膜的形态变化状况并通过建立Logistic模型对影响疗效的可能因素行回归分析。结果：经FESS术后，本组治愈、有效和无效患者分别有64名、28名和7名，总有效率为93.9%，观察发现清洁阶段、转归阶段和上皮化阶段的主要形态变化分别为炎症浸润、术腔水肿及形态恢复。经回归分析发现，术后治疗情况、医嘱执行情况、钩突处理和变应性作用为影响FESS术疗效的关键因素。结论：FESS术的疗效与术腔黏膜的恢复效果与术后的治疗情况及变应性作用密切相关，而黏膜形态的变化主要由结痂、水肿至恢复。而积极配合术后治疗、合理改良钩突可提升疗效。 [关键词]AS FESS 黏膜形态 相关性 DOI:10.3760/cma.j.issn.0376-2491.2014.44.034 作者单位： 陕西 716000， 延安大学附属医院耳鼻咽喉头颈外科 The Mucous Changes of Patients with AS after Functional Endoscopic Sinus Surgery and Its Relevant Factors Zhen Xiling, Zhao Yuxiang, Liu Tao Abstract: Objective To observe the mucous changes of patients with AS after functional endoscopic sinus surgery (FESS) and to investigate the factors that may affect curative effect of FESS. Method 98 cases of patients with AS taken FESS in the authorsrsquo; hospital from March 2013 to March 2014 were collected and Logistic regression model was established to observe their mucous changes in different periods after surgery through regression analysis. Result After FESS, there were 64 patients cured, 28 effective and 7 invalid, with a total effective rate of 93.9%. Observation showed that the main mucous change in the cleaning stage was inflammatory infiltrates, in prognosis stage was cavity hydrops, and in epithelial stage was shape restoration. Regression analysis demonstrated that postoperative treatment, implementation of doctors advice, uncinate process and allergic effect were the crucial factors affecting FESS. Conclusion The curative effect of FESS is closely related to the recovery of cavity mucosa, postoperative treatment and allergic effect. The changes of mucosa are from incrustation to hydrops to restoration. Positive cooperation with postoperative treatment and reasonable uncinate process improvement can improve FESS curative effect. Key w