鼻腔冲洗对慢性鼻窦炎患者术后疗效的影响

Influence of nasal irrigations on the postoperative curative effect of patients with chronic sinusitis

目的探讨鼻腔冲洗对慢性鼻窦炎术后疗效的影响。方法选择357例行鼻内镜手术的慢性鼻窦炎患者，术后给予激素抗感染治疗，根据患者自愿原则选择术后是否鼻腔冲洗，分别于术后2周、6周及4个月电话随访记录患者鼻塞、鼻分泌物、头痛等症状改善情况，依据鼻窦炎生活质量量表（SNOT-20）进行评价。结果冲洗组184例与未冲洗组173例患者术后症状均有改善，随访4个月后两组鼻塞症状评分分别为[0（0，1）]和[0（0，1）]分，脓涕症状评分分别为[0（0，2）]分和[0（0，2）]分，头痛症状评分分别为[0（0，1）]和[0（0，2）]分，冲洗组改善程度优于未冲洗组（Z值分别为-3．176，-4．403，-4．539；P〈0．05）。结论慢性鼻窦炎患者术后进行鼻腔冲洗可改善患者的症状，减少术后的复发。

Objective To study the influence of nasal irrigations on the postoperative curative effect of patients with chronic sinusitis. Methods Total of 357 patients who suffered from chronic sinusitis received transnasal endoscopic surgery from 2008 to 2010 with 184 patients selecting nasal irrigations for the following treatments. Patients were followed up at two weeks, six weeks and four months after the surgeries via telephone. The symptoms of nasal obstruction, nasal discharge and headache were recorded and SNOT-20 was used to measure the quality of life. Results Symptoms of patients were improved ,but improvement in nasal irrigations group was better than that in non-nasal irrigations group. Four months later, the average symptom score of nasal obstruction in nasal irrigations group was [ 0 （0,1） ] which was significantly lower than [ 0 （0,1） ] in non-nasal irrigations group （ Z = - 3. 176, P 〈 0. 05 ）. The average symptom score of nasal discharge in nasal irrigations irrigations group （Z = - 3. 176, P 〈 0. 05 ）. The average symptom score of nasal discharge in nasal irrigations group was [0（0,2）] which was significantly lower than [0 （0,2）] in non-nasal irrigations group （Z = - 4. 403, P 〈 0. 05 ）. The average score of headache was [ 0 （0,1） ] in nasal irrigations group and [ 0 （0,2） ] in non-nasal irrigations group, and the difference was statistically significant （ Z = - 4. 539, P 〈 0. 05 ）. Conclusions Nasal irrigations can improve symptoms of patients with chronic sinusitis and reduce the recurrence.