[1]杨花荣,陈影影,高 英,等.慢性鼻-鼻窦炎伴鼻息肉鼻内镜术后复发调查及危险因素分析[J].陕西医学杂志,2023,52(2):184-187.[doi:DOI:10.3969/j.issn.1000-7377.2023.02.015]
 YANG Huarong,CHEN Yingying,GAO Ying,et al.Recurrence of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery and its risk factors[J].,2023,52(2):184-187.[doi:DOI:10.3969/j.issn.1000-7377.2023.02.015]
点击复制

慢性鼻-鼻窦炎伴鼻息肉鼻内镜术后复发调查及危险因素分析
分享到:

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
52
期数:
2023年2期
页码:
184-187
栏目:
临床研究
出版日期:
2023-02-05

文章信息/Info

Title:
Recurrence of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery and its risk factors
作者:
杨花荣陈影影高 英赵 康王娜娜陈 艳
(延安大学附属医院耳鼻咽喉科,陕西 延安 716000)
Author(s):
YANG HuarongCHEN YingyingGAO YingZHAO KangWANG NanaCHEN Yan
(Department of Otolaryngology,Affiliated Hospital of Yan'an University,Yan'an 716000,China)
关键词:
慢性鼻-鼻窦炎 鼻息肉 鼻内镜手术 术后复发 危险因素 调查研究
Keywords:
Chronic rhinosinusitis Nasal polyp Endoscopic sinus surgery Postoperative recurrence Risk factors Investigation
分类号:
R 765.41
DOI:
DOI:10.3969/j.issn.1000-7377.2023.02.015
文献标志码:
A
摘要:
目的:调查延安大学附属医院2019-2021年慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)鼻内镜术后复发情况,并对复发的危险因素进行分析。方法:回顾性分析在该院接受鼻内镜手术治疗的315例CRSwNP患者的临床资料,根据患者术后1年内是否复发分为复发组和未复发组,比较两组的各项临床指标,筛选影响术后复发的相关危险因素。结果:315例患者中,57例复发(复发组),占18.10%,258例未复发(未复发组),占81.90%; Logistic多因素回归分析结果显示:多发性鼻息肉、鼻中隔偏曲、合并变应性鼻炎、合并支气管哮喘、EOS型鼻息肉、术后感染及不良心理状态是影响CRSwNP鼻内镜术后复发的独立危险因素(均P<0.05)。结论:CRSwNP鼻内镜术后复发率较高,其中病变程度、合并鼻中隔偏曲、有变应性鼻炎/哮喘病史、EOS型鼻息肉、术后感染及不良心理状态与术后复发明显相关,临床应重视上述因素并及时对伴有上述因素的患者实施对症干预,以减少术后复发。
Abstract:
Objective:To investigate the recurrence of chronic rhinosinusitis with nasal polyps(CRSwNP)after endoscopic sinus surgery,and to analyze the related risk factors of recurrence.Methods:The clinical data of 315 patients with CRSwNP who underwent endoscopic sinus surgery were retrospectively analyzed.According to whether the patients relapsed within one year after operation,they were divided into recurrence group and non-recurrence group.The clinical indicators of the two groups were compared to screen the relevant risk factors affecting postoperative recurrence.Results:Among 315 patients,57 cases relapsed(recurrence group),accounting for 18.10%,and 258 cases did not relapse(non-recurrence group),accounting for 81.90%.Logistic regression analysis showed that multiple nasal polyps,deviated nasal septum,allergic rhinitis,bronchial asthma,EOS nasal polyps,postoperative infection and adverse psychological status were independent risk factors for postoperative recurrence of CRSwNP(all P<0.05).Conclusion:CRSwNP has a high recurrence rate after endoscopic sinus surgery.Among them,the degree of lesion,nasal septum deviation,history of allergic rhinitis/asthma,EOS nasal polyps,postoperative infection and adverse psychological status are significantly related to postoperative recurrence.Clinical attention should be paid to the above factors and symptomatic intervention should be implemented in patients with the above factors in time to reduce postoperative recurrence.

参考文献/References:

[1] 陈艳丽,宋 鹏,刘接威,等.慢性鼻窦炎伴鼻息肉患者鼻腔黏膜组织白细胞介素-17A表达特征及检测临床意义[J].陕西医学杂志,2022,51(5):612-616.
[2] Hopkins C.Chronic rhinosinusitis with nasal polyps[J].New England Journal of Medicine,2019,381(1):55-63.
[3] 刘 爽,马文成,隋 强,等.鼻窦炎口服液联合布地奈德超声雾化鼻吸入 对慢性鼻-鼻窦炎术后患者黏膜形态和功能转归的影响[J].陕西中医,2020,41(7):929-931,944.
[4] 谢 军,曾海燕,严亿军,等.经鼻内镜和显微镜经鼻蝶入路手术治疗垂体腺瘤卒中临床对比研究[J].陕西医学杂志,2019,48(11):1532-1534,1537.
[5] Rahman AS,Hwang PH,Alapati R,et al.Indications and outcomes for patients with limited symptoms undergoing endoscopic sinus surgery[J].American Journal of Rhinology & Allergy,2020,34(4):502-507.
[6] 王成硕,张 罗.内镜鼻窦手术治疗慢性鼻-鼻窦炎伴鼻息肉疗效的预测[J].中华耳鼻咽喉头颈外科杂志,2017,52(2):152-156.
[7] Hellings PW,Fokkens WJ,Bachert C,et al.Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis:A euforea-aria-epos-airways ICP statement[J].Allergy,2017,72(9):1297-1305.
[8] 陈璀璀,李永磊,芦二永.通窍鼻炎方对慢性鼻窦炎患者体内Foxa2、黏蛋白MUC5AC、HIF-1α水平的影响[J].陕西中医,2018,39(8):1105-1108.
[9] Bae JS,Ryu G,Ji HK,et al.Effects of Wnt signaling on epithelial to mesenchymal transition in chronic rhinosinusitis with nasal polyp[J].Thorax,2020,75(11):982-993.
[10] Takabayashi T,Tanaka Y,Susuki D,et al.Increased expression of lastin in nasal polyp of patients with nonsteroidal anti nflammatory drug exacerbated respiratory disease[J].Allergy,2018,74(7):1307-1316.
[11] Wu XF,Kong WF,Wang WH,et al.Enhanced recovery after surgery protocols in functional endoscopic sinus surgery for patients with chronic rhinosinusitis with nasal polyps:A randomized clinical trial[J].Chinese Medical Journal,2019,132(3):253-258.
[12] Bartier S,Coste A,Béquignon E.Biotherapy and treatment of adult primary chronic rhinosinusitis with nasal polyps:Cellular and molecular bases[J].European Annals of Otorhinolaryngology,Head and Neck Diseases,2020,138(5):355-362.
[13] 潘泽如,陈红先,詹淑洁.慢性鼻-鼻窦炎伴鼻息肉患者鼻内镜术后鼻息肉复发的影响因素[J].医学综述,2021,27(13):2695-2699.
[14] Canonica GW,Malvezzi L,Blasi F,et al.Chronic rhinosinusitis with nasal polyps impact in severe asthma patients:Evidences from the Severe Asthma Network Italy(SANI)registry[J].Respiratory Medicine,2020,166:5947.
[15] 肖锶瑶,张纾难,熊轶敏,等.Notch信号通路对变应性鼻炎的免疫调控机制及中药干预作用的研究进展[J].现代中西医结合杂志,2021,30(23):616-222.
[16] 杨玉成,张 玥.慢性鼻窦炎伴鼻息肉的整体评估与个体化精准治疗[J].中华耳鼻咽喉头颈外科杂志,2022,57(2):217-221.
[17] Kandikattu HK,Venkateshaiah S,Mishra A.Synergy of Interleukin(IL)-5 and IL-18 in eosinophil mediated pathogenesis of allergic diseases[J].Cytokine & Growth Factor Reviews,2019,47:83-98.
[18] 吴鸿泉,刘 展,覃宇铭.慢性鼻-鼻窦炎伴鼻息肉患者鼻内镜术后复发的危险因素及相关模型构建[J].中国耳鼻咽喉颅底外科杂志,2021,27(5):559-564.
[19] 冯 娟,王 燕,阳玉萍,等.慢性鼻-鼻窦炎伴鼻息肉患者鼻内镜术后复发的危险因素分析[J].新疆医科大学学报,2018,41(6):670-673.
[20] 吴湘明,冯勇军,曾春荣,等.老年慢性鼻-鼻窦炎伴鼻息肉患者鼻内镜术后复发的影响因素分析[J].中国耳鼻咽喉头颈外科,2021,28(1):38-40,44.

相似文献/References:

[1]周 凯,王延辉,秦晓雯△,等.低剂量克拉霉素在慢性鼻-鼻窦炎鼻内镜术中的应用及对患者血清ECP、TIgE水平影响*[J].陕西医学杂志,2020,49(8):1025.[doi:DOI:10.3969/j.issn.1000-7377.2020.08.028]
 ZHOU Kai,WANG Yanhui,QIN Xiaowen,et al.Application of low-dose clarithromycin in nasal endoscopy and its influence on serum ECP and TIgE levels in patients with chronic rhinosinusitis[J].,2020,49(2):1025.[doi:DOI:10.3969/j.issn.1000-7377.2020.08.028]
[2]陈艳丽,宋 鹏,刘接威,等.慢性鼻窦炎伴鼻息肉患者鼻腔黏膜组织白细胞介素-17A表达特征及检测临床意义[J].陕西医学杂志,2022,51(5):612.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.023]
 CHEN Yanli,SONG Peng,LIU Jiewei,et al.Expression characteristics and clinical significance of interleukin-17A in nasal mucosa of patients with chronic rhinosinusitis with nasal polypsis[J].,2022,51(2):612.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.023]
[3]张军军,丁雪瑞.可降解鼻窦药物支架临床应用研究进展[J].陕西医学杂志,2022,51(5):638.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.029]
 ZHANG Junjun,DING Xuerui.Clinical research progress of bioabsorbable corticosteroid-eluting sinus stents[J].,2022,51(2):638.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.029]
[4]朱旭利,李 安,高 静,等.不伴下呼吸道疾病的慢性鼻窦炎患者肺功能损害相关性分析[J].陕西医学杂志,2023,52(8):1029.[doi:DOI:10.3969/j.issn.1000-7377.2023.08.020]
 ZHU Xuli,LI An,GAO Jing,et al.Lung function impairment in chronic rhinosinusitis patients without lower respiratory tract disease and its correlation analysis[J].,2023,52(2):1029.[doi:DOI:10.3969/j.issn.1000-7377.2023.08.020]

备注/Memo

备注/Memo:
基金项目:陕西省自然科学基础研究计划项目(2020JM-551); 延安大学附属医院科技研究计划项目(2021PT-05)
更新日期/Last Update: 2023-02-06