Li Yuan, Zhang Ge-hua, Liu Xian, Ye Jin, Zeng Zhuan-ping
Department of Otorhinolaryngology Head and Neck Surgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China.
ORL J Otorhinolaryngol Relat Spec. 2008;70(2):113-7. doi: 10.1159/000114534. Epub 2008 Apr 15.
We aimed to determine the clinical prognostic factors of chronic rhinosinusitis after endoscopic sinus surgery (ESS) in order to better guide the management of patients.
A total of 254 patients with chronic rhinosinusitis after ESS with a follow-up of 24 months were evaluated retrospectively. Clinical grouping, hyperplasia of the ethmoid bone, anatomic variations, allergy, polyps, previous sinonasal surgery and recurrent polyps were analyzed.
The success rates were 64.4 and 91.9% with and without hyperplasia of the ethmoid bone, 87.6 and 86.4% with and without anatomic variations, 67.9 and 92.0% with and without allergy, 81.0 and 94.0% with and without polyps, 72.8 and 93.6% with and without history of surgery and 52.3 and 94.3% with and without recurrent polyps. In logistic multiple regression analysis, allergy (p = 0.0002; estimate, -4.2094), nasal polyps (p = 0.0007; estimate, -3.6393) and history of surgery (p < 0.0001; estimate, -5.0938) were found to reach a statistically significant level.
We propose that allergy, polyps and history of surgery might be significant indicators of poor prognosis after ESS.
我们旨在确定内镜鼻窦手术（ESS）后慢性鼻窦炎的临床预后因素，以便更好地指导患者的管理。
回顾性评估了254例ESS术后慢性鼻窦炎患者，随访时间为24个月。分析了临床分组、筛骨增生、解剖变异、过敏、息肉、既往鼻窦手术和复发性息肉情况。
筛骨有增生和无增生患者的成功率分别为64.4%和91.9%；有解剖变异和无解剖变异患者的成功率分别为87.6%和86.4%；有过敏和无过敏患者的成功率分别为67.9%和92.0%；有息肉和无息肉患者的成功率分别为81.0%和94.0%；有手术史和无手术史患者的成功率分别为72.8%和93.6%；有复发性息肉和无复发性息肉患者的成功率分别为52.3%和94.3%。在逻辑多元回归分析中，发现过敏（p = 0.0002；估计值，-4.2094）、鼻息肉（p = 0.0007；估计值，-3.6393）和手术史（p < 0.0001；估计值，-5.0938）达到统计学显著水平。
我们认为过敏、息肉和手术史可能是ESS术后预后不良的重要指标。
