内镜鼻窦手术对慢性鼻窦炎患者临床结局、鼻腔通畅度及嗅觉功能的影响

文献信息

中文摘要

目的： 评估内镜鼻窦手术（ESS）对慢性鼻窦炎（CRS）患者治疗效果、鼻腔通畅度及嗅觉功能的影响。
方法： 选取天津市环湖医院收治的225例CRS患者。对照组为100例接受鼻内上颌窦开窗术的患者，观察组为125例接受内镜鼻窦手术的患者。收集并比较两组患者的数据，包括治疗效果、症状缓解、鼻腔通畅度（鼻腔最小横截面积（NMCA）、鼻气道阻力（NAR）、鼻腔容积（NCV））、鼻腔黏液纤毛功能（黏液纤毛清除速度和清除率）、内镜表现（Lund-Kennedy评分）和嗅觉功能、血清炎症标志物（高敏C反应蛋白[hs-CRP]、肿瘤坏死因子α[TNF-α]、白细胞介素-6[IL-6]）、术后并发症、使用中文版鼻窦结局测试20[SNOT-20]评估的生活质量，以及短期复发（6个月和12个月复发率）。此外，评估炎症标志物与症状恢复之间的相关性。
结果： 观察组的总有效率显著更高，症状缓解、黏液纤毛功能、内镜表现、嗅觉功能和生活质量的改善均大于对照组。两组在鼻腔通畅度指标方面表现出相当的改善。观察组的血清炎症标志物、总体并发症发生率以及6个月和12个月复发率均显著低于对照组。相关性分析显示，Δhs-CRP与嗅觉功能障碍之间存在显著正相关（r = 0.156，P = 0.019），ΔIL-6与鼻塞之间存在显著正相关（r = 0.175，P = 0.008）；然而，这些相关性的临床意义有限。
结论： ESS为CRS患者提供了可靠的治疗获益，值得在临床上更广泛地应用。

英文摘要

OBJECTIVE: To evaluate the effects of endoscopic sinus surgery (ESS) on treatment efficacy, nasal patency, and olfactory function in patients with chronic rhinosinusitis (CRS).
METHODS: A total of 225 patients with CRS admitted to Tianjin Huanhu Hospital were selected. The control group comprised 100 patients who underwent intranasal maxillary antrostomy, while the observation group included 125 patients who underwent endoscopic sinus surgery. Data were collected from both groups were compared, including treatment efficacy, symptom resolution, nasal patency (nasal minimum cross-sectional area (NMCA), nasal airway resistance (NAR), nasal cavity volume (NCV)), nasal mucociliary function (mucociliary clearance velocity and clearance rate), endoscopic findings (Lund-Kennedy score) and olfactory function, serum inflammatory markers (high-sensitivity C-reactive protein [hs-CRP], tumor necrosis factor α [TNF-α], interleukin-6 [IL-6]), postoperative complications, quality of life using the Chinese version of the Sino-Nasal Outcomes Test 20 [SNOT-20], and short-term recurrence (6-month and 12-month recurrence rates). In addition, the correlation between inflammatory markers and symptom recovery was evaluated.
RESULTS: The observation group demonstrated a significantly higher total effective rate, greater improvements in symptom resolution, mucociliary function, endoscopic findings, olfactory function, and quality of life, than the control group. Both groups showed comparable improvement in nasal patency indices. Serum inflammatory markers, the overall complication rate, and 6- and 12-month recurrence rates were significantly lower in the observation group than in the control group. Correlation analysis revealed a significant positive correlation between Δhs-CRP and olfactory dysfunction (r = 0.156, P = 0.019), and between ΔIL-6 and nasal obstruction (r = 0.175, P = 0.008); however, the clinical relevance of these correlations was limited.
CONCLUSION: ESS provides reliable therapeutic benefits for patients with CRS and merits broader clinical adoption.