局部麻醉下慢性鼻-鼻窦炎伴鼻息肉的手术治疗：适应证和结果。
Surgical management of chronic rhinosinusitis with nasal polyps under local anaesthesia: indications and results.
机构信息
Aix-Marseille Univ, APHM, Department of Oto-Rhino-Laryngology and Head and Neck Surgery, La Conception University Hospital, Marseille Cedex, France.
Aix-Marseille Univ, APHM, IUSTI, CNRS, Department of Oto-Rhino-Laryngology and Head and Neck Surgery, La Conception University Hospital, Marseille Cedex, France.
出版信息
Acta Otorhinolaryngol Ital. 2023 Feb;43(1):42-48. doi: 10.14639/0392-100X-N1984.
OBJECTIVE
Our objective was to specify the indications and duration of effectiveness of Awake Patient Polyp Surgery (APPS) in Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Secondary objectives were to evaluate complications and Patient-Reported Experience (PREMs) and Outcome Measures (PROMs).
METHODS
We collected information regarding sex, age, comorbidities and treatments. Duration of effectiveness was the duration of non-recurrence defined by the time between APPS and a new treatment. Nasal Polyp Score (NPS) and Visual Analogic Scales (VAS, from 0/10 to 10/10) for nasal obstruction and olfactory disorders were assessed preoperatively and one month after surgery. PREMs were evaluated using a new tool: the APPS score.
RESULTS
Seventy-five patients were enrolled (SR = 3.1, mean age = 60.9 ± 12.3 years). 60% of patients had a previous history of sinus surgery, 90% had stage 4 NPS and more than 60% had overuse of systemic corticosteroids. Mean time of non-recurrence was 31.3 ± 2.3 months. We found a significant improvement (all p < 0.001) for NPS (3.8 ± 0.4 1.5 ± 0.6), VAS obstruction (9.5 ± 1.6 0.9 ± 1.7) and VAS olfactory disorders (4.9 ± 0.2 3.8 ± 1.7). Mean APPS score was 46.3 ± 5.5/50.
CONCLUSIONS
APPS is a safe and efficient procedure in the management of CRSwNP.
目的
我们的目的是明确慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者清醒状态下鼻内息肉切除术（APPS）的适应证和有效性持续时间。次要目标是评估并发症、患者报告的体验（PREMs）和结局测量（PROMs）。
方法
我们收集了有关性别、年龄、合并症和治疗的信息。有效性持续时间是指 APPS 与新治疗之间无复发的时间间隔。术前和术后一个月评估鼻息肉评分（NPS）和鼻腔阻塞及嗅觉障碍的视觉模拟量表（VAS，范围 0/10 至 10/10）。使用新工具评估 PREMs：APPS 评分。
结果
共纳入 75 例患者（SR = 3.1，平均年龄为 60.9 ± 12.3 岁）。60%的患者有鼻窦手术史，90%的患者 NPS 分期为 4 期，超过 60%的患者长期滥用全身皮质激素。无复发时间的平均时间为 31.3 ± 2.3 个月。我们发现 NPS（3.8 ± 0.4 1.5 ± 0.6）、鼻塞 VAS（9.5 ± 1.6 0.9 ± 1.7）和嗅觉障碍 VAS（4.9 ± 0.2 3.8 ± 1.7）均有显著改善（均 p < 0.001）。APPS 平均得分为 46.3 ± 5.5/50。
结论
APPS 是 CRSwNP 管理的一种安全有效的方法。
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