DIP内镜评分法在慢性鼻窦炎鼻内镜手术中的应用

摘要

目的 探讨DIP内镜评分法应用慢性鼻窦炎鼻内镜手术评估的可行性.方法 选取2013年1月~2016年7月期间在我院行鼻内镜手术的慢性鼻窦炎患者500例,随机分为对照组和实验组,每组各250例.所有患者均于术前和术后行鼻内镜检查并录像.实验组患者采用DIP评分法对内镜录像进行评分,对照组患者则采用Lund-Mackay CT评分法进行内镜录像评分.分别于术前及术后3个月进行评分结果比较,术后3月时进行疗效比较分析.结果 内镜录像评分结果显示,术前、术后及术后随访3个月时的两种内镜录像评分均显示正相关.分别比较手术前后二组内镜录像评分结果,手术后及术后3个月时的评分均明显降低,具有统计学意义(P<0.05).实验组和对照组的总有效率分别为92.00%和79.20%,对照组明显低于实验组(P<0.05).结论 DIP内镜评分法在慢性鼻窦炎鼻内镜手术评估中具有良好应用价值,值得推广.%Objective To investigate the feasibility of DIP scoring procedure for nasal endoscopic video among cases with chronic sinusitis treated by endoscopic sinus surgery based on a clinical trial. Methods Included in this trial were 500 cases with chronic sinusitis treated by endoscopic sinus surgery in our hospital from Jan., 2013 to Jul., 2016, randomly divided into control group (CG) and observing group (OG), with 250 cases in each. All these cases were examined by nasal endoscopy before and after endoscopic sinus surgery respectively, with video taken during the examining course. The endoscopic video of OG was scored by DIP scoring procedure, while that of CG scored by Lund-Mackay CT scoring procedure. Then, the scores of these two groups were analyzed in a comparative way before and after the surgery and 3 months later following the surgery. Therapeutic effect was summed up by the end of following up period lasted for three months. Results As shown from the scores of nasal endoscopic video scoring, there was a positive relationship between the two scoring procedures either before the operation or after the surgery, even 3 months later following the surgery. When compared the systematic scores taken during the therapeutic course in either group, significantly decreased scores could be seen after the surgery and 3 months later following the surgery, with significantly statistical significance (P<0.05). Furthermore, the total effective rates were 92% and 79.20% for OG and CG respectively, with an obviously higher rate in OG (P<0.05) as well. Conclusion DIP procedure for nasal endoscopic video scoring holds much better clinical feasibility in the evaluation of endoscopic sinus surgery for the treatment of chronic sinusitis. Therefore, it is worth popularizing in clinical practice.