目的：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。方法：选取2010年1月~2012年1月我院耳鼻喉科门诊收治的118例慢性鼻鼻窦炎伴鼻息肉患者为研究对象，按随机法分为观察组和对照组，每组59例。两组患者均行Messerklinger术式单行鼻内镜手术，观察组患者术后使用布地奈德鼻喷剂喷鼻，2次/d，每次1喷，持续喷鼻6个月。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：观察组患者治疗总有效率显著高于对照组，且随访半年内观察组患者复发率显著低于对照组，差异均具有统计学意义（P<0.05）。在术后治疗后，观察组患者在术后1、4、12、24周鼻气道阻力明显小于对照组，差异具有统计学意义（P<0.05）。两组患者在术前嗅觉功能评分差异不显著，不具有统计学意义（P>0.05）。在术后治疗后，观察组患者在术后1、4、12、24周嗅觉功能评分明显小于对照组，差异具有统计学意义（P<0.05）。 两组患者在治疗期间均未出现明显不良反应。 结论：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，疗效显著，术后复发率低，，能够有效改善患者临床症状和嗅觉功能，值得临床推广使用。
Objective: To observe the effect of glucocorticoid infiltration on the short-term curative effect and olfactory function in patients with chronic rhinosinusitis complicated with nasal polyps after endoscopic sinus surgery. Methods: 118 patients with chronic rhinosinusitis complicated with nasal polyps who were admitted and treated in the outpatient department of Otorhinolaryngology in our hospital between January 2010 and January 2012 were selected as the study subjects and were randomized into observation group and control group, 59 cases in each group. Both groups were treated by Messerklinger type single endoscopic sinus surgery. The observation group was treated with budesonide nasal spray, twice/d, one spray for once, for six months. The treatment before surgery and surgical methods in the control group were the same as the observation group, and after surgery, the control group was not treated with budesonide nasal spray. The other methods and regular nasal endoscopy in the control group were the same with observation group. The total effective rate, postoperative recurrence rate, nasal airway resistance and improvement of olfactory function were observed and compared between the two groups. Results: The total effective rate in the observation group was significantly higher than that in the control group, and the recurrence rate within six months was significantly lower (P<0.05). At 1 week, 4 weeks, 12 weeks and 24 weeks after surgery, the nasal airway resistance in observation group was significantly less than that in control group (P<0.05). There was no significant difference in olfactory function score between the two groups before surgery (P>0.05). At 1 week, 4 weeks, 12 weeks and 24 weeks after surgery, the olfactory function scores in observation group were significantly less than those in control group (P<0.05). There were no obvious adverse reactions in the two groups during the treatment. Conclusion : To apply glucocorticoid infiltration in the treatment of patients with chronic rhinosinusitis complicated with nasal polyps after endoscopic sinus surgery, the curative effect is significant, the postoperative recurrence rate is low.. It can effectively relieve the clinical symptoms and improve olfactory function in patients. It is worthy of clinical application.
Key words: Chronic rhinosinusitis; Endoscopic sinus surgery; Glucocorticoid; Olfactory function
引用本文 / How to Cite This Article
余滋中,付艳乔,李国义.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[J]. 国际精神病学杂志, , (): -