内镜鼻窦手术后慢性鼻窦炎的临床预后因素
Clinical prognostic factors of chronic rhinosinusitis after endoscopic sinus surgery.
作者信息
Li Yuan, Zhang Ge-hua, Liu Xian, Ye Jin, Zeng Zhuan-ping
机构信息
Department of Otorhinolaryngology Head and Neck Surgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, PR China.
出版信息
ORL J Otorhinolaryngol Relat Spec. 2008;70(2):113-7. doi: 10.1159/000114534. Epub 2008 Apr 15.
OBJECTIVE
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.
METHODS
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.
RESULTS
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.
CONCLUSIONS
We propose that allergy, polyps and history of surgery might be significant indicators of poor prognosis after ESS.
目的
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。
方法
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。
结果
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。
结论
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。
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