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鼻息肉综合药物与手术治疗的评估。I:功能结果。

Evaluation of the combined medical and surgical treatment in nasal polyposis. I: functional results.

作者信息

Bonfils Pierre

机构信息

Department of Oto-Rhino-Laryngology - Head Neck Surgery, European Hospital Georges Pompidou, University Paris-Descartes, Paris, France.

出版信息

Acta Otolaryngol. 2007 Apr;127(4):436-46. doi: 10.1080/00016480600895078.

Abstract

CONCLUSION

This prospective study is the first in the literature to present long-term results of a combined medical and surgical treatment in patients with nasal polyposis (NP) including strict inclusion criteria, analysis of the results in terms of clinical amelioration, polyp size reduction, and steroid consumption. The results of the present study show that combined surgery and corticosteroid therapy is effective in the treatment of NP.

OBJECTIVE

Most publications on outcome after functional endoscopic sinus surgery (FESS) include patients with various pathologies. The aim of this study was to provide reference information for FESS in patients with NP with strict inclusion and exclusion criteria.

MATERIALS AND METHODS

This was a prospective study involving 194 consecutive patients. Clinical symptoms, polyp size, and steroid consumption were evaluated before and after FESS (mean follow-up, 74 months). An actuarial analysis using the Kaplan Meier life table method was performed with regard to the 3- and 5-year symptoms control rates.

RESULTS

All symptoms were improved after FESS. The 5-year actuarial nasal obstruction control rate was 65.8%. The 5-year actuarial severe posterior rhinorrhea control rate was 82.9%. The 5-year actuarial smell loss and anosmia control rates were 17.7% and 65.8%, respectively. Polyp volume and steroid consumption decreased significantly after FESS.

摘要

结论

本前瞻性研究是文献中首个呈现鼻息肉(NP)患者联合药物与手术治疗长期结果的研究,包括严格的纳入标准,以及从临床改善、息肉大小缩小和类固醇使用情况方面对结果进行分析。本研究结果表明,手术联合皮质类固醇治疗对NP有效。

目的

大多数关于功能性内镜鼻窦手术(FESS)术后结果的出版物纳入了患有各种病变的患者。本研究的目的是为具有严格纳入和排除标准的NP患者的FESS提供参考信息。

材料与方法

这是一项前瞻性研究,纳入了194例连续患者。在FESS前后评估临床症状、息肉大小和类固醇使用情况(平均随访74个月)。采用Kaplan-Meier生命表法对3年和5年症状控制率进行精算分析。

结果

FESS后所有症状均有改善。5年精算鼻塞控制率为65.8%。5年精算严重后鼻漏控制率为82.9%。5年精算嗅觉丧失和嗅觉缺失控制率分别为17.7%和65.8%。FESS后息肉体积和类固醇使用量显著下降。

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