慢性鼻窦炎伴鼻息肉患者功能性内镜鼻窦手术前检查对早期预后的预测价值
Predictive Value of Preoperative Examinations for Early Prognosis After Functional Endoscopic Sinus Surgery in Chronic Rhinosinusitis With Nasal Polyps.
文献信息
| PMID | 42860249 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Xinyi Zheng |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. |
| 期刊 | Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery |
| SCI 分区 | Q2 |
| IF | 2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
背景： 功能性内镜鼻窦手术（FESS）仍是药物治疗难治性慢性鼻窦炎伴鼻息肉（CRSwNP）的主要治疗方式。本研究旨在评估常规术前检查对CRSwNP患者FESS术后早期手术结局的预测价值。
方法： 这项前瞻性队列研究评估了常规术前评估能否预测181例双侧CRSwNP患者FESS术后的早期结局。术前评估包括Lund-Mackay CT评分、Lund-Kennedy内镜评分、症状视觉模拟量表（VAS）、SNOT-22和外周血嗜酸性粒细胞计数。患者在术后2周、1个月、3个月和6个月接受随访。
结果： 术前VAS与2周症状改善的相关性最强（r=0.633），在多变量分析中仍是独立预测因子（β=0.58）。术前SNOT-22也可独立预测2周结局（β=0.15）。在3个月时，血嗜酸性粒细胞计数可预测内镜改善（r=0.305），而术前Lund-Kennedy评分可强烈预测6个月内镜结局（r=0.508）。
结论： 常规术前评估为CRSwNP患者FESS术后早期结局提供了有价值的预测信息。我们期望这些发现能够支持整合多模式术前评估，以指导患者咨询和术后管理预期。
英文摘要
BACKGROUND: Functional endoscopic sinus surgery (FESS) remains a primary treatment modality for chronic rhinosinusitis with nasal polyps (CRSwNP) refractory to medical management. This study aimed to evaluate the predictive value of routine preoperative examinations for early surgical outcomes following FESS in patients with CRSwNP.
METHODS: This prospective cohort study evaluated whether routine preoperative assessments predict early outcomes after FESS in 181 patients with bilateral CRSwNP. Preoperative evaluations included Lund-Mackay CT scores, Lund-Kennedy endoscopy scores, symptom Visual Analogue Scale (VAS), SNOT-22 and peripheral blood eosinophil counts. Patients were followed postoperatively at 2 weeks, 1, 3 and 6 months.
RESULTS: Preoperative VAS showed the strongest correlation with 2-week symptom improvement (r = 0.633), remaining an independent predictor in multivariate analysis (β = 0.58). Preoperative SNOT-22 also independently predicted 2-week outcomes (β = 0.15). At 3 months, blood eosinophil counts predicted endoscopic improvement (r = 0.305), while preoperative Lund-Kennedy scores strongly predicted 6-month endoscopic outcomes (r = 0.508).
CONCLUSIONS: Routine preoperative assessments provide valuable predictive information for early postoperative outcomes following FESS in CRSwNP. We expect these findings to support the integration of multimodal preoperative assessment to guide patient counselling and postoperative management expectations.