功能性鼻内镜鼻窦手术后术腔清理(附1080例临床分析)

目的：探讨功能性鼻内镜鼻窦手术后术腔清理对鼻窦结构及上皮功能恢复的影响。方法：1080例均为采取Messerklinger术式完成功能性鼻内镜鼻窦手术的病例。手术后2周进行第一次鼻腔鼻窦清理，以后每隔2周一次，共进行4或4次以上清理至术腔基本上皮化。结果：112例手术后1个月术腔基本上皮化，456例手术后2个月术腔基本上皮化，255例手术后3个月术腔基本上皮化；98例出现术后窦口闭锁，176例出现术腔粘连，在术腔清理过程中进行处理，这些并发症均消失；95例出现术后复发而需要进一步手术治疗。结论：术腔粘膜的再上皮化对功能性鼻内镜鼻窦手术后鼻窦功能的恢复至关重要，这一过程一般需要1～3个月甚至更长时间，手术后规范化的术腔清理能早期发现并处理粘膜病变、术腔狭窄及窦口阻塞，因而术后清理对提高功能性鼻内镜鼻窦手术的疗效有重要价值。

Postoperative management of functional endoscopic sinus surgery (clinical analysis of 1080 cases)

Objective To explore the effects of postoperative management for patients with functional endoscopic sinus surgery on recovery of sinus cavity' structure and sinus epithelial function. Method The subjects consist of 1080 cases received Messerklinger surgical approach. All cases received the first clearing treatment 2 weeks after dischargment. Then this treatment was performed 4 or more times at 2 weeks intervals at the following days until the sinus cavity are almost epithelized. Results The results showed that 112 cases, 456 cases, 255 cases were epithelized one month, two months and three months, respectively. 98 cases occurred ostiums atresia, 176 cases presented sinus adhesion, All this complications disappeared after clearing treatment. 95 cases experienced recurrence and need further surgery. Conclusion Reepithelization is very important for recovery of surgical cavity mucosa, however, this process requires 1-3 months, while regular postoperative clearance might find early pathological changes and treat narrow and obstructive surgical cavity. Therefore, postoperative management might be valuable for increasing effect of functional endoscopic sinus surgery.