摘要
目的 探究慢性鼻鼻窦炎功能性鼻内镜术后不同冲洗液处理对复发情况的影响。方法 将2015年4月至2016年4月于 我院择期行功能性鼻内镜手术的66例慢性鼻鼻窦炎患者采用随机数字表法分为两组。两组患者均于功能性鼻内 镜术后进行术腔冲洗治疗。对照组给予500mL生理盐水冲洗术腔,观察组以10mg地塞米松+500mL生理盐水进行冲 洗。比较两组冲洗治疗前、治疗2周及4周后的主要症状、体征评分;比较两组治疗总有效率;且均对两组随访3 个月,观察两组患者复发率。结果 观察组冲洗治疗2周、4周后症状评分(3.24±1.28)分、(2.13±1.15)分和体 征评分(4.02±1.19)分、(3.42±0.96)分较治疗前及对照组冲洗治疗后2周、4周后症状评分(4.36±1.14)分、 (3.57±1.27)分和体征评分(4.83±1.22)分、(4.02±0.85)分显著较低,差异有统计学意义(P<0.05)。观察组治 疗总有效率90.91%高于对照组69.70%,复发率15.15%低于对照组42.42%,差异有统计学意义(P<0.05)。结论 对慢 性鼻鼻窦炎功能性鼻内镜术后患者给予术后冲洗鼻腔治疗,可显著改善患者的临床症状、体征,降低其复发率;地 塞米松和生理盐水制成的冲洗液效果更佳。
Objective To study effects of different irrigations on the recurrence of chronic rhinosinusitis after functional endoscopic sinus surgery. Methods From Apr. 2015 to Apr. 2016, a total of 66 patients with chronic rhinosinusitis in our hospital were taken as the clinical research objects, and they were randomly divided into control group and observation group. Both groups accepted nasal irrigation treatment by 500mL normal saline after functional endoscopic sinus surgery, besides, the observation group was given additional 10mg dexamethasone. The main symptoms and signs were compared between the two groups before treatment, 2 and 4 weeks after treatment; the total effective rates of the two groups were also compared; and the recurrence rates of the two groups were observed after 3 months follow up. Results 2 and 4 weeks after treatment, the scores of symptoms in the observation group were respectively (3.24±1.28) and (2.13±1.15) which were not only lower than those in the control group (4.36±1.14) and (3.57±1.27), but also lower than before treatment, and their differences were statistically significant (P<0.05), the scores of signs in the observation group were respectively (4.02±1.19) and (3.42±0.96) which were not only lower than those in the control group (4.83±1.22) and (4.02±0.85), but also lower than before treatment, and their differences were statistically significant (P<0.05). The total effective rate in the observation group was 90.91% which was higher than that in the control group 69.70%, and the recurrence rate in the observation group was 15.15% which was lower than that in the control group 42.42%, and their differences were statistically significant (P<0.05). Conclusion: Nasal irrigation treatment after functional endoscopic sinus surgery for chronic rhinosinusitis can obviously improve patients' clinical symptoms and signs and reduce recurrence rate, and the irrigation of dexamethasone and normal saline has better effect.
【关键词】慢性鼻鼻窦炎;鼻内镜;鼻腔冲洗液;临床疗效;复发
【中图分类号】R765.4
【文献标识码】A
【DOI】10.3969/j.issn.1009-3257.2017.01.008
前言
慢性鼻窦炎是指鼻腔阻塞、需氧菌感染、外伤和 药物等因素损伤鼻窦的慢性化脓性炎症[1]。功能性鼻 内镜(FESS)是该病保守治疗无效者的常规手术治疗方案。但大量实验资料显示,鼻内镜手术只是治疗的开 始,术后的有效处理是预防术腔粘膜发生新病变、复 发的关键[2]。现将66例慢性鼻鼻窦炎功能性鼻内镜术后患者作为研究对象,给予不同冲洗液冲洗术腔,并 观察其疗效。结果报道如下。
罕少疾病杂志
第24卷, 第 1 期
2019年11月
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