| Objective:To evaluate the surgical outcomes of patients with chronic rhinosinusitis(CRS)before and after functional sinus surgery(FESS),and to explore the factors associated with postoperative FESS in patients with CRS.Look for indicators that can have a reliable and stable effect on the efficacy of CRS surgery.As far as possible to predict the efficacy of patients with CRS,reduce disputes between doctors and patients,guide perioperative treatment,to improve the overall surgical outcome of patients with CRS,reduce the pain of patients,reduce the risk of recurrence after surgery.Methods;A total of 204 patients with CRS who were diagnosed and treated in the Department of Otorhinolaryngology,Second People’s Hospital of Wuhu City from January 2015 to May 2017 were selected as subjects.There were 142 males and 62 females,aged 17-75 years,with an average age of(42.6±13.3)years.All patients were diagnosed according to the diagnosis and treatment of European sinusitis and nasal polyps submitted in 2012(EPOS 2012)and related diagnostic criteria for the diagnosis and treatment of chronic sinusitis(Kunming,2012).All 204 patients with CRS were divided into 148 cases of chronic rhinosinusitis with nasal polyps(CRSwNP)and chronic rhinosinusitis without nasal polyps(CRSsNP)depending on whether they were accompanied by nasal polyps.Group 56 cases.Preoperative complete case data collection including subjective symptom visual analogue scale(VAS score),CT score(Lund-Mackay score),endoscopic score(Lund-Kennedy score),peripheral blood Eos ratio,nasal excision tissue Eos infiltration ratio and combined asthma The patient was followed for 1 year.The main content of follow-up was the VAS score and the Lund-Kennedy score.According to the Kunming guidelines,the surgical outcomes of all CRS patients are divided into:1.The effective group was 146(healed and improved);2.The 58 patients in the ineffective group(not healed).Various data were processed and analyzed using SPSS 25.0 statistical software.Results:In this study,the effective rate was 204.6%(146/204)in 204 patients with CRS,67.57%(100/148)in the CRSwNP group,and 82.1%(46/56)in the CRSsNP group.),the difference was statistically significant(P<0.05).Univariate analysis showed that the Eos ratio in the CRSwNP group,the proportion of Eos in peripheral blood,the Lund-Mackay score,the Lund-Kennedy score,the VAS score of subjective symptoms,and whether there was a difference in asthma(P<0.05).The Eos ratio in the CRSsNP group,the proportion of Eos in peripheral blood,and the presence or absence of asthma were statistically different(P<0.05).Bivariate correlation analysis showed that the ratio of Eos in peripheral blood of CRSwNP group was positively correlated with tissue Eos ratio,and the correlation coefficient was r=00.606,P<0.01.Multivariate binary logistic regression analysis showed that only the tissue Eos infiltration rate eventually entered the regression model of the CRSwNP group,while the CRSsNP group did not have any factors or indicators to enter the regression model.The receiver operating characteristic curve(ROC curve)was used to analyze the tissue Eos infiltration rate and predict the postoperative curative effect of CRSwNP patients.The area under the curve(AUC)was 0.824,and the optimal cutoff value of tissue Eos ratio was 42.3%.The corresponding sensitivity was 75.0%.The specificity was 80.0%.Peripheral blood Eos ratio is expected to be effective in patients with CRSwNP.AUC=0.608,the best cutoff value is 6.4%,the corresponding sensitivity is 43.8%,and the specificity is 84.0%.Conclusion:There are many factors influencing the surgical outcome of patients with chronic nasal-sinusitis.The surgical results of patients with nasal polyps and non-nasal polyps are not completely different.For patients with CRSwNP,tissue Eos ratio is an independent risk factor for surgical outcome in CRSwNP patients.Although the Eos infiltration rate was moderately positively correlated with the peripheral blood Eos ratio,the ratio of Eos infiltration to Eos infiltration was more stable and reliable than the peripheral blood Eos,≥42.3%.It can be used as an objective indicator to predict poor prognosis in patients with postoperative CRSwNP and to guide perioperative treatment. |
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