功能性鼻内窥镜术后慢性鼻窦炎患者短期布地奈德盐水盥洗疗效观察

Clinical effect of budesonide nasal irrigation shortly after functional endoscopic endonasal surgery of chronic sinusitis

目的观察短期布地奈德盐水盥洗对功能性鼻内窥镜术(FESS)术后慢性鼻窦炎患者的应用效果。方法将慢性鼻窦炎入院行FESS术病例55例分为实验组31例与对照组24例,55例患者先于红外影像手术导航系统下进行全麻FESS手术,FESS术后3 d,清除鼻腔填塞物,内镜清理鼻腔后开始鼻腔盥洗。实验组以布地奈德盐水盥洗(0.5 mg布地奈德/200 mL生理盐水/侧),2次/d;对照组以生理盐水盥洗,并以布地奈德鼻喷剂喷鼻,2次/d。共计14 d。分别于术前进行鼻部症状VAS评分(鼻塞、鼻涕、嗅觉、头面痛)和Kennedy评分、盥洗前后LKES评分和SNOT评分。比较两组治疗前后各评分。结果实验组与对照组VAS评分分别为(17.80±3.22)、(18.66±3.43)分,Kennedy评分分别为(3.45±1.09)、(3.37±1.05)分,两组比较,P均>0.05。两组盥洗后LKES评分和SNOT评分比较,P均为0.00。治疗过程均未发现不良事件。结论慢性鼻窦炎患者FESS术后短期内进行布地奈德盐水盥洗可有效改善鼻腔症状、促进鼻腔黏膜恢复。

Objective To investigate the therapeutic effectiveness and feasibility of budesonide nasal irrigation shortly after Functional Endoscopic sinus surgery( FESS) of chronic sinusitis by observing the recovery of the nasal mucosa. Methods Fifty-five participants with chronic rhino-sinusitis were divided into treated( budesonide and saline irrigation) and control( saline irrigation)groups according to irrigation contents twice daily. VAS( nose obstruction,nasal discharge,smelling,and facial pain) and Kennedy scores were collected before FESS,while LKES and SNOT-22 scores were collected and compared before and after nasal irrigation.Results VAS scores were 17.80±3.22 in the treated group and 18.66±3.43 in the control group( P<0.05). Kennedy scores were3.45±1.09 in the treated group and 3.37± 1.05 in the control group( P< 0.05). Scores of LKES and SNOT-22 were compared between the treated and control groups( P<0.05). There were no adverse events during treatment and irrigation. Conclusions Nasal symptoms shortly after FESS could be improved with budesonide irrigation,especially by reducing nasal mucositis after surgery and promoting nasal mucosa recovery.