规范化药物治疗慢性鼻-鼻窦炎的近期疗效观察

发布时间：2018-03-08 00:32

本文选题：鼻窦炎　切入点：鼻息肉　出处：《临床耳鼻咽喉头颈外科杂志》2014年02期 　论文类型：期刊论文

【摘要】：目的:评价规范化药物治疗慢性鼻-鼻窦炎患者的疗效。方法:采用前瞻性研究设计,依据2008年制订的"慢性鼻-鼻窦炎诊断和治疗指南",对54例慢性鼻-鼻窦炎患者联合使用鼻内局部糖皮质激素、大环内酯类(14元环)药物、黏液促排剂和鼻腔冲洗规范化治疗并随访3个月。采用视觉模拟量表(VAS)、鼻腔鼻窦结局测试-20中文版量表(SNOT-20CV)、Lund-Mackay CT方法和Lund-Kennedy鼻内镜方法进行主客观评分,综合评价患者治疗前后的临床疗效。结果:①规范化药物治疗3个月后,VAS、SNOT-20CV、CT和鼻内镜整体评分均较治疗前明显改善(均P0.01)。②慢性鼻-鼻窦炎伴息肉(CRSwNP)组和慢性鼻-鼻窦炎不伴息肉(CRSsNP)组治疗前后均差异有统计学意义(均P0.01)。CRSwNP组药物治疗3个月后主观评价有效率为66.7%,CT评价有效率为94.4%;CRSsNP组的主观评价有效率为91.7%,CT评价有效率为97.2%。③CRSwNP组和CRSsNP组比较,主观疗效中仅治愈率差异有统计学意义,好转率和无效率均差异无统计学意义(均P0.05);而CT评价中,治愈率和好转率均差异有统计学意义(均P0.05)。④CRS患者以其自测为基础的主观调查表与客观评估之间呈正相关性。结论:联合鼻内局部糖皮质激素、大环内酯类(14元环)药物、黏液促排剂和鼻腔冲洗规范化治疗CRS疗效肯定。
[Abstract]:Objective: to evaluate the efficacy of standardized drugs in the treatment of chronic rhinosinusitis. According to the guidelines for the diagnosis and treatment of chronic rhinosinusitis made in 2008, 54 patients with chronic rhinosinusitis were treated with intranasal glucocorticoids and macrolides. The standard treatment of mucus effluents and nasal lavage was followed up for 3 months. The subjective and objective scores were evaluated by visual analogue scale (VASA), nasal sinus outcome test (SNOT-20), Lund-Mackay CT (Lund-Mackay CT) and Lund-Kennedy nasal endoscopy (Lund-Kennedy). Results after 3 months of standardized drug therapy, VASSNOT-20 CVCT and the overall score of nasal endoscopy were significantly improved compared with those before treatment (P0.01n.2 chronic rhinosinusitis with polyposis CRSwNP) and chronic rhinosinosinusitis with CRSwNPs. There was significant difference between the two groups before and after treatment (P 0.01). The subjective evaluation effective rate of CRSwNP group was 66.7% after 3 months of drug therapy. The effective rate of CT evaluation was 94.4%. The effective rate of CT evaluation was 91.7%. The effective rate of CT evaluation in CRSwNP group was 97.2.3CRSwNP group compared with CRSsNP group. In subjective curative effect, the difference of cure rate was statistically significant, but there was no significant difference between improvement rate and invalid rate (all P 0.05), but in CT evaluation, there was no significant difference. There was a positive correlation between subjective questionnaire and objective evaluation in patients with CRS (P0.050.4CRS). Conclusion: local glucocorticoids and macrolides are associated with intranasal glucocorticoids and macrolides. Mucus effluents and nasal cavity irrigation are effective in the standardized treatment of CRS.
【作者单位】：温州医科大学第一附属医院耳鼻咽喉科;昆明医科大学附属第一医院耳鼻咽喉科;昆明医科大学附属第一医院影像科;
【分类号】：R765.4

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