克拉霉素治疗鼻咽癌放疗后鼻窦炎的临床观察

Clinical observation of clarithromycin treatment for nasosinusitis after nasopharyngeal carcinoma radiotherapy

目的:观察大环内酯类药物克拉霉素治疗鼻咽癌放疗后鼻窦炎的临床效果。方法:对鼻咽癌放疗1年后并发鼻窦炎的24例患者,口服小剂量克拉霉素,250mg/d,疗程12～20周;根据慢性鼻窦炎视觉模拟量表(VAS)、Lund-Mackay鼻窦CT影像评分系统,通过治疗前后比较,对治疗效果进行综合评估。结果:治疗前与治疗后及停药6个月后相比,VAS评分和CT影像评分差异均有统计学意义(P<0.01),治疗后与停药6个月后相比,两种评分结果差异均无统计学意义(P>0.05)。疗效评价为非常好9例,好11例,不好4例。结论:小剂量克拉霉素长期治疗鼻咽癌放疗后鼻窦炎有比较明显的临床效果,是鼻咽癌放疗后鼻窦炎较好的治疗方法。

Objective：To observe the clinical treatment effectiveness of clarithromycin for nasosinusitis after nasopharyngeal carcinoma radiotherapy.Method：Twenty-four cases of nasosinusitis after one year nasopharyngeal carcinoma radiotherapy were treated with the oral clarithromycin of small dosage（250 mg everyday）.The course of treatment were for 12 to 20 weeks.The treatment effectiveness were evaluated with the chronic nasosinusitis visual analog quality table mark system（VAS）and Lund-Mackay nasal sinuses CT image mark system before and after treatment.Result：The VAS mark and CT image mark have significant deviation（P〈0.01） among pretherapy,post-treament and 6 months after drug withdrawal.No significant deviation was found（P〉0.05） between post-treament and 6 months after drug withdrawal. The treatment effectiveness was judged for very good is 9 cases, for the good is 11 cases and for the bad is 4 cases.Conclusion：The clarithromycin of small dosage for long-term treatment of nasosinusitis after nasopharyngeal carcinoma radiotherapy has positive clinical treatment effectiveness,which is a better treatment method.