糖皮质激素联合鼻内镜手术治疗对鼻息肉患者疗效及鼻黏膜组织细胞因子的影响

Curative effect of glucocorticoids combined with endoscopic sinus surgery on nasal polyps and influence on cytokines in nasal mucosa tissues

目的探讨糖皮质激素联合鼻内镜手术治疗鼻息肉效果及对鼻黏膜组织炎症因子水平的影响。方法选取2014年6月至2020年6月在平顶山市第一人民医院治疗的150例鼻息肉患者为研究对象,采用常规鼻内镜手术治疗的患者为对照组,在联合糖皮质激素与鼻内镜手术治疗者设为观察组,比较两组治疗效果及患者鼻黏膜组织炎症因子水平的变化情况,记录不良反应。结果两组治疗有效率(96.00%VS 84.00%)比较差异有统计学意义(P<0.05);观察组治疗后血清白细胞介素-5(IL-5)、白细胞介素-17(IL-17)均显著低于对照组,差异有统计学意义(P<0.05);治疗后两组Lund-Mackey及SNOT-20评分均降低,且观察组治疗后以上评分均低于对照组,差异有统计学意义(P<0.05);观察组术后并发症发生率(4.00%)显著低于对照组(13.33%),差异有统计学意义(P<0.05)。结论糖皮质激素联合鼻内镜手术能显著降低鼻息肉患者术后并发症及鼻黏膜炎性反应,改善鼻黏膜免疫功能及患者生活质量,效果较佳,值得在临床上推广应用。

Objective This study was conducted to investigate the clinical effects of glucocorticoids combined with endoscopic sinus surgery in the treatment of nasal polyps and the influence on inflammatory factors in nasal mucosa tissues.Methods Totally 150 patients with nasal polyps treated in the hospital between June 2014 and June 2020 were selected as study subjects.According to the envelope result,150 patients were divided into observation group(n=75)and control group(n=75).The control group were treated with conventional endoscopic sinus surgery,while the observation group were treated with glucocorticoids and endoscopic sinus surgery.Therapeutic effects and changes in levels of inflammatory factors in nasal mucosa tissues were compared between the two groups,and adverse reactions were recorded.Results There was a statistically significant difference in the response rate between the two groups(96.00%VS 84.00%,P<0.05).After treatment,serum IL-5 and IL-17 were significantly lower in the observation group than those in the control group,and the differences were statistically significant(P<0.05).After treatment,Lund-Mackey and SNOT-20 scores were reduced,and the above scores were lower in the observation group than in the control group.The differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 4.00%,significantly lower than 13.33%in the control group,and the difference was statistically significant(P<0.05).Conclusion Glucocorticoids combined with endoscopic sinus surgery can significantly reduce postoperative complications and nasal mucosa inflammatory reactions in patients with nasal polyps while improving the patients’nasal mucosa immune function and quality of life,with good effect.Therefore,it is worthy of clinical application.