46例经鼻内窥镜鼻窦手术失败原因分析

目的：为提高经鼻内窥镜鼻窦手术疗效。方法：分析经鼻内窥镜治疗慢性鼻窦炎、鼻息肉病例335例，其中疗效欠佳或无效病例46例（67侧），总结失败的原因。结果：比较常见的经鼻内窥镜手术疗效不佳或失败的原因有术腔粘连14例（19侧）、术后随访和换药不及时13例（21侧）、术中病灶除不彻底8例（11侧）、相关病变没有处理9例（12侧）、原因不明2例（4侧）。结论：提高手术疗效的3个关键是①根据慢性鼻窦炎、鼻息肉发生的病理机制和鼻腔、鼻窦解剖学理论来指导手术；②规范内的内窥镜围手术期处理；③鼻腔局部和全身系统用药。

Analysis of causes of failure in endoscopic sinus surgery

Aim: WTBZ In order to archiere the curative effect of endoscopic sinus surgery (ESS). WTHZ Methods: WTBZ335 cases of chronic sinusitis and nasal polyps were treated with ESS, and the curative effect in 46 cases were not avchiaved or were not satisfied.WTHZ Results:WTBZ There are many factors that will cause defeated or not excellent curative effect. The most common causes are adhesions of operative cavity in 14 cases, no following-up and no exchanging dressing in time after operation in 13 cases, no cleaning the diseased tissue thoroughly in 8 cases, no dealing with the related diseases in 9 cases, unknown reason in 2 cases. WTHZ Conclusion:WTBZ It is very important to improve the ESS technique in reducing the recurrence of nasal polyps and sinusitis and improving the curative effect of ESS, to follow-up and dress the wound regularly after the operation, using medication in topic and all over the body.