鼻内镜手术合并大环内酯类抗生素治疗鼻窦炎43例

Endoscopic sinus surgery plus macrolide antibiotics for sinusitis:analysis of 43 cases

目的:评价鼻内镜手术治疗合并术后利用大环内酯类抗生素治疗鼻窦炎的疗效,探讨鼻窦炎患者治疗前后血清中IL-17及其受体的表达及血清中总IgE的变化。方法:鼻窦内窥镜行病侧上颌寞自然口扩大及下鼻道开窗双进路,彻底清除鼻腔、鼻窦病变组织,术后采用大环内酯类抗生素治疗;采用酶联免疫法检测30例患者治疗前后血清中IL-17,IL-17R及IgE的含量。结果:治疗30例,其中术后病理证实鼻寞真菌球20例,治愈20例;曲霉菌感染23例,治愈10例,6个月随访无复发;与只治疗前相比,手术治疗后鼻窦炎患者血清IL-17,IL-17R及IgE的含量均明显降低。结论:鼻内镜手术是治疗真菌性鼻一鼻窦炎的主要方法,IL-17和IL-17R均参与鼻窦炎的发病过程,可作为诊断鼻窦炎的新指标,鼻内镜术后使用大环内酯类抗生素进一步巩固治疗,可降低复发率。

Objective：To evaluate the effect of endoscopic sinus surgery combined with macrolide antibiotics on the treatment of sinusitis,discuss the expressions of IL-17 and IL-17R in Serum of allergic rhinitis patients.Methods：Epidemiology side of the maxillary sinus endoscopy lonely natural population increase,and the windows double inferior meatus into the road,Complete removal of nasal and sinus lesions,postoperative use of macrolide antibiotics;Enzyme-linked immunosorbent assay（ELISA） was used to detect the IL-17,IL-17R and IgG levels.Results：20 cases of fungal ball nose lonely,cured 20 cases;aspergillus infection in 23 cases,10 cases were cured,6 month follow up no recurrence.43 patients had no complications during the treatment.IL-17,IL-17R and IgE levels were significantly decreased.Conclusion：Endoscopic nasal surgery is the main treatment method of fungal sinusitis,IL-17 and IL-17R are involved in the pathogenesis of rhinitis,they can be used as a new diagnostic index for sinusitis,macrolide antibiotics can reduce the relapse rate.