鼻内窥镜术对慢性鼻-鼻窦炎患者的疗效观察及护理

摘要

目的：探讨鼻内窥镜手术治疗慢性鼻-鼻窦炎（CRS）的临床疗效并总结护理要点。方法选取145例 CRS 患者为研究对象，均给予鼻内窥镜手术治疗，同时加强围术期护理。治疗及护理3个月后，进行临床疗效及并发症发生率评价，并比较治疗前、治疗后3个月鼻阻力值、鼻黏膜中 IL-5数量等各项鼻功能指标以及鼻塞、头痛等症状评分及生活质量变化。结果145例患者中，治愈86例，好转53例，无效6例，总有效率为95．86％；出现眶内血肿4例，泪管损伤1例，中隔粘连1例，筛窦腔粘连2例，术后鼻出血5例，并发症发生率为8．97％。治疗3个月后，患者前鼻阻力值、黏膜炎性细胞计数及鼻黏膜中IL-5数量均显著低于治疗前（P ＜0．05），鼻塞、鼻分泌物等症状评分显著低于治疗前（P ＜0．05），治疗3个月后，患者 SF-36生活质量量表各项评分均较治疗前显著升高，差异具有统计学意义（P ＜0．05）。结论对于 CRS 患者，鼻内镜手术具有疗效确切、显著改善患者鼻功能、并发症发生率低等优点，在此同时加强对患者的护理，有助于改善其生活质量。%Objective To investigate the curative effect of nasal endoscopic surgery in the treatment of chronic rhinosinusitis (CRS)and to summarize the nursing points.Methods A total of 145 CRS patients in our hospital were selected as the research objects,and were treated with en-doscopic surgery as well as strengthening the perioperative nursing.The clinical curative effect and complication rate of patients after 3 months were compared.Nasal resistance value,the number of IL-5 in the nasal mucosa of the nasal function,quality of life score and nasal congestion,headache and other symptoms change before treatment and 3 months after the treatment were compared. Results In the 145 patients,there were 86 cured cases,53 improved cases and 6 ineffective cases, the total efficiency was 95.86%.There were 4 cases with orbital hematoma,1 cases with lacrimal duct injury,1 case with septal conglutination,2 cases with ethmoid sinus cavity adhesion,5 cases with nasal bleeding after operation,the complication rate was 8.97%.After 3 months of treat-ment,the anterior nasal resistance value,the number of IL-5 and the count of inflammatory cells in nasal mucosa mucosa were significantly lower than those before treatment (P <0.05).Nasal con-gestion,nasal discharge and other symptoms scores were significantly lower than those before treat-ment (P <0.05).After 3 months of treatment,the SF-36 quality of life scale scores were signifi-cantly higher than those before treatment,the difference was statistically significant (P <0.05). Conclusion Nasal endoscopic operation has good curative effect for patients with CRS,signifi-cantly improves nasal function,and reduces complication rate.And strengthening nursing of pa-tients helps to improve their quality of life.