普米克令舒鼻雾化吸入在功能性鼻窦内镜手术围术期的疗效分析

A clinical analysis of nebulized Pulmicore respules around FESS period

目的:探讨功能性鼻窦内镜手术(FESS)术后应用普米克令舒鼻雾化吸入的近期疗效。方法:44例慢性鼻窦炎(Ⅱ型Ⅱ期)患者,均行FESS,21例患者(治疗组)术后第2天开始鼻雾化吸入普米克令舒共10d,另23例患者(对照组)术后常规用雷诺考特喷鼻。2组患者均于术后第2天及第14天行临床症状和体征评分,第14天同时行鼻内镜下术腔上颌窦窦口黏膜活检,显微镜下计数每百个炎性细胞中嗜酸粒细胞和中性粒细胞的数量,统计2组患者症状体征总分值及总有效率有无统计学意义,以及嗜酸粒细胞和中性粒细胞计数百分比有无统计学意义。结果:2组患者术后第2天总分值差异无统计学意义,第14天治疗组总分值低于对照组(P<0.01),总有效率高于对照组,但差异无统计学意义(P>0.05);2组嗜酸粒细胞计数差异无统计学意义(P>0.05),中性粒细胞计数治疗组低于对照组(P<0.01)。结论:普米克令舒配合PARISINUS鼻雾化吸入器使用,能够充分到达上颌窦窦腔内,其作用面积更广泛,起效更快,控制急性炎症感染的效果更好,在FESS术后应用,能明显减轻患者急性炎症和水肿反应,减少黏膜水肿、术腔粘连和窦口狭窄等并发症,其近期疗效优于鼻喷雾剂型的同类药物。

Objective： To evaluate the recent clinical efficiency of nebulized Pulmicore respules after FESS. Method：Forty-four patients with chronic sinusitis who received FESS, 21 cases were treated with aerosol therapy： Pulmicore respules, the other 23 cases were treated with Budesonide aqueous nasal spray. All the patients were asked for return at the day 14. Efficacy was evaluated by measurement of nasal symptom scores and sign scores at day 2 and day 14, the biopsy of the membrane on the gap of sinus maxillary were taken to count the eosinophil cell and neutrophil cell in per hundred inflammation cells under microscope and analyze the statistic of the symptom scores,sign scores,efficiency,percentage of the eosinophil cell and the neutrophil cell between two groups at day 14. Result：There was no significant differences on the total score between two groups at the day 2, while the therapy group was remarkably lower than that in the control group at the day 14（ P〈0.01）. The therapy group had a higher efficacity than the control group but no significance（ P 〉0.05）. The percentage of the eosinophil was no significant differences between two groups（ P 〉0.05）, while the percentage of the neutrophil was lower in the therapy group（ P 〈0.01）. Conclusion： Pulmicore respules and Budesonide are the same type hormones, but Pulmicore respules is a fine granule mixed liquid, with PARI SINUS nasal spray, it can arrive at the whole cavity of the sinus maxillary and be absorbed faster and in a larger space. We consider that nebulized Pulmicore respules after FESS can relieve the acute inflammation and oedema, it can also reduce the complication of the surgery. The recent clinical efficiency of the Pulmicore respules is much better than other aqueous nasal spray.