鼻内镜术后糖皮质激素浸润对慢性鼻-鼻窦炎伴鼻息肉患者近期疗效及嗅觉功能的影响

发布时间：2018-05-11 06:07

本文选题：慢性鼻鼻窦炎 + 鼻内镜手术　；参考：《基因组学与应用生物学》2017年07期

【摘要】：为观察鼻内镜术后糖皮质激素浸润对慢性鼻-鼻窦炎伴鼻息肉患者近期疗效及嗅觉功能的影响。我们收集2010年01月~2012年01月诊治的慢性鼻-鼻窦炎伴鼻息肉患者的临床资料,共118例纳入本次研究,按随机法分为观察组(n=59)和对照组(n=59),两组患者均接受Messerklinger术式单行鼻内镜手术,术后观察组患者给予糖皮质激素(布地奈德鼻喷剂)喷鼻,2次/d,1喷/次,持续治疗半年。对照组患者术前处理和手术方法同观察组,术后除不使用布地奈德喷剂喷鼻处理,其余方法及定期进行鼻内镜复查同观察组。观察比较两组患者治疗总有效率、术后复发率、鼻气道阻力及嗅觉功能改善情况。结果显示,观察组54例显效(总有效率91.52%),对照组显效43例(总有效率72.88%),两组总疗效比较差异显著(p0.05),且在半年复发率方面观察组(6.78%)显著低于对照组(20.34%)(p0.05);术后,两组鼻气道阻力及嗅觉功能均较术前明显改善(p0.05),且观察组术后1、4、12、24周两项指标评定结果均优于对照组(p0.05),且观察组术后用药并未增加不良反应,两组对比无统计学意义(p0.05)。鼻内镜术后应用糖皮质激素浸润治疗慢性鼻-鼻窦炎伴鼻息肉患者疗效安全,通过缓解患者鼻腔内炎症反应来减轻患者临床症状,同时促进鼻腔功能恢复,术后复发率低,值得临床推广使用。
[Abstract]:To observe the effect of glucocorticoid infiltration on the short-term curative effect and olfactory function in patients with chronic rhinosinusitis and nasal polyps after nasal endoscopy. We collected clinical data of patients with chronic rhinosinusitis and nasal polyps diagnosed and treated from January 2010 to January 2012. A total of 118 patients were included in this study. The patients were randomly divided into two groups: the observation group (n = 59) and the control group (n = 59). The patients in both groups were treated with Messerklinger single nasal endoscopic surgery. The patients in the observation group were treated with glucocorticoid (budesonide nasal spray) 2 times / d / d for half a year. In the control group, the preoperative treatment and operation methods were the same as those in the observation group, except for budesonide spray nasal treatment, the other methods and the regular nasal endoscopy reexamination were carried out in the same observation group. The total effective rate, recurrence rate, nasal airway resistance and olfactory function were observed and compared between the two groups. The results showed that 54 cases in the observation group (the total effective rate was 91.52%) and 43 cases in the control group (the total effective rate was 72.88%) were significantly lower than those in the control group (P 0.05%, P 0.05, and in the half year recurrence rate, P 0.05), and the total effective rate in the observation group was significantly lower than that in the control group (20.34%, P 0.05; after operation, there was a significant difference between the two groups in the total effective rate (P 0.05). The nasal airway resistance and olfactory function of the two groups were significantly improved compared with those before operation, and the evaluation results of the two indexes in the observation group were better than those in the control group at 24 weeks after operation, and the adverse reactions were not increased in the observation group. There was no significant difference between the two groups. After nasal endoscopy, glucocorticoid infiltration was used to treat chronic rhinosinusitis with nasal polyps. It is worth popularizing in clinic.
【作者单位】：十堰市太和医院湖北医药学院附属医院;
【基金】：十堰市科学技术研究及开发项目(15Y303)资助
【分类号】：R765.9

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