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目的 探讨慢性鼻窦炎、鼻息肉内窥镜鼻窦手术中切除或保留中鼻甲对手术疗效的影响。方法 对 16 1例 (2 82侧 )作功能性内窥镜鼻窦手术病人进行术后随访 ,并行内窥镜复查 ,将中鼻甲切除组 75例 (139侧 )和保留组 86例 (143侧 )的随访结果进行比较。结果 两组手术总有效率 :切除组为 6 5例 (86 .7% ) ;保留组为 70例 (81.4% ) ,两组比较差异无显著性 (P >0 .0 5 ) ;而息肉复发率两组分别为 2 0 .86 %和 31.47% (P <0 .0 5 ) ;中鼻甲粘连分别为 5 .76 %和 2 3.0 8% (P <0 .0 1) ,以上两项两组间比较差异均有显著性。筛窦术腔闭塞率分别为 15 .11%和 18.18% (P >0 .0 5 ) ;全组病人无萎缩性鼻炎、鳞状上皮化以及鼻中隔鼻甲形成。结论 对多发性鼻窦炎和鼻息肉及中鼻甲息变严重 ,且与正常粘膜无明显界限的病人进行功能性内窥镜鼻窦手术时 ,适当切除中鼻甲可减少息肉复发和中鼻甲粘连 ,但对症状改善与中鼻甲保留组之间差异无显著性
Objective To investigate the effect of removing or retaining middle turbinate on the curative effect of chronic sinusitis and nasal polyps endoscopic sinus surgery. Methods One hundred and sixteen patients (282 sides) with functional endoscopic sinus surgery were followed up and endoscopic retrospectively. Totally 75 cases (139 sides) of middle turbinate resection group and 86 cases (143 sides) of retention group were enrolled in this study. The follow-up results were compared. Results The total operative efficiency of the two groups was 65 cases (86.7%) in the resection group and 70 cases (81.4%) in the retention group, with no significant difference between the two groups (P> 0.05) The rates of the two groups were 20.86% and 31.47% (P <0. 05) respectively. The middle turbinate adhesions were respectively 5.76% and 2.308% (P <0.01) Between the differences were significant. The occlusion rate of ethmoid sinus cavity was 15.11% and 18.18% respectively (P> 0.05). There was no atrophic rhinitis, squamous metaplasia and nasal septum formation in all patients. Conclusions For patients with multiple sinusitis, nasal polyps, and middle turbinate disease who have severe severities and no obvious borderline with normal mucosa during functional endoscopic sinus surgery, appropriate removal of middle turbinate can reduce polyp recurrence and middle turbinate adhesions, There was no significant difference between symptom improvement and middle turbinate retention group