鼻内镜下不同手术入路治疗上颌窦良性病变的疗效及安全性对比

Comparison with efficacy and safety of the treatment with different operation approach under nasal endoscope in benign maxillary sinus lesions

摘要:

目的 探讨鼻内镜下不同手术入路治疗上颌窦良性病变的疗效及安全性。方法 回顾性分析2020年1月－2022年1月该院诊治的80例上颌窦良性病变患者的临床资料，根据不同手术方法，分为A组（n = 40）和B组（n = 40）。A组采用鼻内镜下中鼻道联合上颌窦根治术，B组采用鼻内镜下经中鼻道上颌窦开窗后，再经泪前隐窝入路手术。比较两组患者临床疗效、手术指标、视觉模拟评分法（VAS）、Lund-Kennedy鼻内镜评分、不良反应发生率和复发率。结果 B组治疗总有效率明显高于A组，术中出血量明显少于A组，手术时间和住院时间明显短于A组，术后6个月，两组患者VAS和Lund－Kennedy评分较术前明显降低，且B组明显低于A组，B组不良反应总发生率和总复发率明显低于A组，差异均有统计学意义（P < 0.05）。结论 鼻内镜下经中鼻道上颌窦开窗后，再经泪前隐窝入路手术，治疗上颌窦良性病变，疗效显著，可缓解患者疼痛，安全性高。值得临床推广应用。

Abstract:

Objective To explore the validity and security of treatment of different operation approach under nasal endoscope in patients with benign maxillary sinus lesions.Methods A retrospective analysis was performed on 80 patients with benign maxillary sinus lesions diagnosed and treated from January 2020 to January 2022, and they were divided into group A (n = 40) and group B (n = 40) according to the operative method. Group A was treated with middle nasal meatus combined with Caldwell-Luc operation under nasal endoscope, and group B was treated with middle nasal meatus antrostomy first and anterior lacrimal recess approach later under nasal endoscope. The clinical efficacy, operation index, visual analogue scale (VAS), Lund-Kennedy endoscopic score, adverse reactions and recurrence rate of both groups were compared before and after operation.Results The total effective rate was sensibly higher in group B than that in group A, the intraoperative blood loss was sensibly less in group B than that in group A, the operation and hospitalization time were sensibly shorter in group B than those in group A, 6 months after operation, the VAS and Lund-Kennedy scores were sensibly decreased in comparison with those before operation, and group B was sensibly decreased in comparison with those in group A, the total incidence rate of adverse reactions and recurrence rate were sensibly lower in group B than those in group A, the differences were statistically significant (P < 0.05).Conclusion The surgical treatment of patients with benign maxillary sinus lesions through the middle nasal meatus and the anterior lacrimal recess approach under nasal endoscope is effective and can relieve the pain of patients with high safety. It is worthy of clinical application