Larsen K, Tos M
ENT Clinic, Esbjerg, Denmark.
Eur Arch Otorhinolaryngol. 1997;254 Suppl 1:S85-8. doi: 10.1007/BF02439732.
A long-term follow-up study was performed on randomly selected patients after simple snare polypectomies. There were 243 patients, of whom 211 underwent endoscopic examination. There were 154 males and 57 females and median age was 57.7 years. Median period of follow-up was 8 years (range, 38-145 months). The median number of polypectomies was 1.6 (range, 1-15). Polyp eosinophilia was recorded in 97% of the cases. From life-table analysis the 5-year rate for two or less polypectomies was 80% (95% confidence intervals, 75-86%). Symptoms and findings were recorded at a median time of 56 months from the last polypectomy. At this time 70% of the patients denied blocked nose or excessive secretions. Seventeen per cent of the group claimed loss of sense of smell, while 28% stated that it was poor. At follow-up, large polyps were found in 3% of the patients, moderately sized ones in 30% and small in 42%. No polyps were visible in 25%. Patients with asthma (26%) had more polypectomies than those without (median, 2.4 versus 1.4). Patients with a history of non-steroidal antiinflammatory drug intolerance (7%) had the highest number of polypectomies. Previous troublesome sinusitis and allergy seemed not to exert major influence on the number of polypectomies needed. In the primary care of nasal polyp patients, the majority only need minor or limited surgery or only medical treatment.
对随机选择的患者在进行简单圈套器息肉切除术后进行了一项长期随访研究。共有243例患者，其中211例接受了内镜检查。男性154例，女性57例，中位年龄为57.7岁。中位随访时间为8年（范围38 - 145个月）。息肉切除的中位次数为1.6次（范围1 - 15次）。97%的病例记录有息肉嗜酸性粒细胞增多。通过寿命表分析，息肉切除次数为两次及以下的5年发生率为80%（95%置信区间，75 - 86%）。症状和检查结果在距最后一次息肉切除术后的中位时间56个月时记录。此时，70%的患者否认有鼻塞或分泌物过多的情况。该组中有17%的患者称嗅觉丧失，而28%的患者表示嗅觉较差。随访时，3%的患者发现有大息肉，30%为中等大小息肉，42%为小息肉。25%的患者未见息肉。患有哮喘的患者（26%）比未患哮喘的患者息肉切除次数更多（中位次数，2.4次对1.4次）。有非甾体抗炎药不耐受史的患者（7%）息肉切除次数最多。既往有鼻窦炎和过敏病史似乎对所需息肉切除次数没有重大影响。在鼻息肉患者的初级治疗中，大多数患者仅需要小型或有限的手术，或仅需药物治疗。
