轮廓化鼻内镜手术联合氯雷他定治疗难治性慢性鼻-鼻窦炎的效果观察

Efficacy of contorted endoscopic nasal surgery combined with Loratadine in treatment of refractory chronic rhinosinusitis

目的探讨轮廓化鼻内镜手术联合氯雷他定治疗难治性慢性鼻-鼻窦炎的临床治疗效果。方法选取2016年3月—2020年2月安阳地区医院收治的难治性慢性鼻-鼻窦炎患者70例作为研究对象,根据治疗方式分为实验组(35例)与对照组(35例)。实验组予以轮廓化鼻内镜手术,对照组予以功能性鼻内镜手术,术后2组均予以氯雷他定片治疗。对比2组治疗前后鼻内镜Lund-Kennedy评分、鼻窦CT Lund-Mackay评分及症状视觉模拟量表(VAS)评分、临床疗效及生活质量。结果治疗后实验组鼻内镜Lund-Kennedy评分(5.32±1.22)分、鼻窦CT Lund-Mackay评分(8.33±2.12)分及嗅觉VAS评分(3.14±0.56)分低于对照组[(7.87±1.46)(11.24±2.23)(4.62±0.71)]分(P<0.001);治疗后实验组治疗有效率(91.43%)高于对照组(71.43%)(P<0.05);末次随访时实验组鼻窦鼻腔结局测试-20评分(4.35±1.68)分低于对照组(6.14±2.32)分(P<0.001)。结论对难治性慢性鼻-鼻窦炎患者采取轮廓化鼻内镜手术联合氯雷他定进行治疗,可明显改善患者临床症状,疗效显著,提高患者生活质量。

Objective To investigate the clinical effect of contorted endoscopic nasal surgery combined with loratadine in the treatment of refractory chronic rhinosinusitis.Methods A total of 70 patients with refractory chronic rhinosinusitis admitted to our hospital from March 2016 to February 2020 were selected as the research subjects,were divided into experimental group(35 cases)and control group(35 cases)according to the treatment methods.The contouring endoscopic surgery was performed in the experimental group,and functional endoscopic surgery was performed in the control group.Both groups were treated with loratadine tablets.Lund-Kennedy score of nasal endoscopy,lund-Mackay score of nasal sinus CT and VAS score of symptoms,clinical efficacy and quality of life were compared between the two groups before and after treatment.Results After treatment,Lund-Kennedy score of nasal endoscopy(5.32±1.22)and CT of sinuses in the experimental group Lund-Mackay score(8.33±2.12)and olfactory VAS score(3.14±0.56)were lower than those in the control group[(7.87±1.46),(11.24±2.23),(4.62±0.71)](P<0.001).After treatment,the effective rate of experimental group(91.43%)was higher than that of control group(71.43%)(P<0.05).At the last follow-up,the-20 score(4.35±1.68)in the experimental group was lower than that in the control group(6.14±2.32)(P<0.001).Conclusion In the treatment of refractory chronic rhinosinusitis,contorted nasal endoscopic surgery combined with loratadine can significantly improve the clinical symptoms and improve the quality of life of patients.