慢性鼻―鼻窦炎伴鼻息肉患者不同类型微生物感染对鼻内镜手术疗效影响.docVIP

慢性鼻―鼻窦炎伴鼻息肉患者不同类型微生物感染对鼻内镜手术疗效影响 　　【摘要】 目的：探讨慢性鼻-鼻窦炎伴鼻息肉（Chronic rhinosinusitis with nasalpolyp，CRSwNP）患者不同类型微生物感染对鼻内镜手术疗效的影响。方法：选择2011年5月-2016年5月本院收治的CRSwNP患者行鼻内镜手术临床案例100例，按照上颌窦分泌物行微生物培养并鉴定结果不同，将其分为微生物培养阴性组（MCN组）26例、细菌培养阳性组（BCP组）51例及真菌培养阳性组（FCP组）23例。三组术前及术后均采用Lund-Kennedy内镜、视觉模拟量表（VAS）及Lund-MackayCT评分进行主观及客观病情评估。结果：MCN组治愈率和总有效率最高，FCP组最低，FCP组总有效均低于MCN?M和BCP组，差异均有统计学意义（P0.05）；术后12个月，MCN组VAS、Lund-Kennedy内镜及Lund-MackayCT评分最低，FCP组均为最高，差异均有统计学意义（P0.05）；术后12个月，MCN组IL-6、IL-10、TNF-α水平均为最低，FCP组均为最高，差异均有统计学意义（P0.05）。结论：微生物感染CRSwNP患者鼻窦内会影响鼻内镜手术疗效，尤其是真菌感染疗效更差，能否通过敏感抗生素治疗而改善CRSwNP患者鼻内镜手术疗效，有待进一步研究。 　　【关键词】 慢性鼻-鼻窦炎； 鼻息肉； 微生物感染； 鼻内镜 　　Effect of Different Types of Microbial Infections on Efficacy of Nasal Endoscopic Surgery in Patients with Chronic Rhinosinusitis withNasalPolyp/LIN Hong-hao，XIE Chao-feng，CHEN Rui-kun.//Medical Innovation of China，2017，14（26）：116-119 　　【Abstract】 Objective：To observe the effect of different types of microbial infections on the nasal endoscopic surgery in patients with chronic rhinosinusitis with nasal polyp（CRSwNP）.Method：From May 2011 to May 2016 100 cases of CRSwNP were selected，according to the different results maxillary sinus secretions microorganism culture and identification，they were divided into microorganism culture negative groups（MCN group）26 cases，germiculture positive group（BCP group）51 cases and fungal culture positive group（FCP group）23 cases.Preoperative and postoperative，three groups used Lund-Kennedyendoscopy，visual analog scale（VAS） and Lund-Mackay CT grading to assessed the subjective and objective condition.Result：The rate of cure and total effective of MCN group were the highest，FCP group were the lowest，the total effective of FCP group were lower than those of MCN group and BCP group，the difference were statistically significant（P0.05）.12 months after the surgery，VAS，Lund-Kennedy，endoscopy and Lund-MackayCT score of MCN group were the lowest，FCP group were the highest，the differences were statistically significant（P0.05