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目的:探讨鼻内镜下额窦开放并置管引流术疗效,以期找到一种提高慢性额窦炎治愈率的有效方法。方法:68例(130侧)慢性额窦炎行功能性鼻内镜额窦手术患者,随机分为3组,A组:鼻内镜下额窦开放术并置双管引流术;B组:鼻内镜下额窦开放术并置管引流、倍氯米松滴注;C组:鼻内镜下单纯额窦开放术。结果:3组患者平均随访18个月,鼻内镜下评价3组患者治愈率,A组为93%,B组为93%,C组为71%。B组与C组疗效比较,差异有统计学意义。未见严重手术并发症。结论:慢性额窦炎手术成功与否与术后额窦开口是否再次狭窄或者闭锁密切相关,鼻内镜下额窦开放术后持续6个月以上置双管引流可降低额窦口再次狭窄或者闭锁概率,而且置管保留6~12个月比较合适。我们建议这种方法应用于病情复杂的成人患者或者任何儿童患者。
OBJECTIVE: To explore the curative effect of frontal sinus opening and catheter drainage under nasal endoscopy in order to find an effective way to improve the cure rate of chronic frontal sinusitis. Methods: Sixty-eight patients (130 sides) with chronic frontal sinusitis undergoing functional endoscopic sinus surgery were randomly divided into three groups: group A: frontal sinus open endoscopic nasal endoscopy combined with double-tube drainage; group B: intranasal Microsurgery frontal sinus surgery and catheter drainage, beclomethasone infusion; C group: nasal endoscopic simple open sinus surgery. Results: The average duration of follow-up was 18 months in three groups. The cure rate of three groups was evaluated by endoscopy, 93% in group A, 93% in group B and 71% in group C. B group and C group, the difference was statistically significant. No serious surgical complications. Conclusions: The success of chronic frontal sinusitis surgery is closely related to whether the frontal sinus opening is stenosed or blocked again. Nasal endoscopic sinus surgery with open drainage for more than 6 months can reduce the restenosis of the frontal ostia or Lock probability, and catheter retention for 6 to 12 months is more appropriate. We recommend this method should be used in patients with complicated adult patients or any children.