纳吸棉联合布地奈德混悬液在内镜鼻窦术后填塞中的应用

Application of nasopore and budesonide suspension on tamping after endoscopic sinus surgery

目的:探讨鼻内镜术后纳吸棉联合布地奈德混悬液填塞术腔的临床效果。方法:随机选取30例行双侧鼻窦内镜手术且完成随访的CRSwNP和CRSsNP患者,分为实验组(左侧鼻腔)和对照组(右侧鼻腔)。实验组在手术结束时用含有布地奈德混悬液的纳吸棉填塞术腔,对照组则单纯使用纳吸棉填塞术腔,分别在术后第2周、第1个月、第3个月时对患者行VAS评分及Lund-Kennedy内镜黏膜形态评分。结果:12组术后第2周、第1、3个月时患者整体不适感及鼻塞、鼻腔分泌物、头痛或头昏、鼻面部胀痛四大主观症状的VAS评分差异均有统计学意义(P<0.05),实验组优于对照组。22组术后第2周、第1、3个月Lund-Kennedy内镜黏膜形态评分各项目得分及总分差异均有统计学意义(P<0.05),实验组优于对照组;术后第1、3个月时,实验组的鼻腔阻力小于对照组(P<0.05)。3术后第3个月,实验组28例(93.3%)病情完全控制,总有效率96.6%;对照组22例(73.3%)病情完全控制,总有效率93.3%。2组间病情完全控制率比较差异有统计学意义(P<0.05);2组间总有效率比较差异无统计学意义(P>0.05)。结论:鼻内镜术后应用含有布地奈德混悬液的纳吸棉填塞术腔,可明显改善患者术后的不适症状,促进黏膜的顺利转归,提高了病情完全控制率。

Objective：To investigate the clinical effect of nasal packing of pulmicort respules combined with nasopore after endoscopic sinus surgery. Method： A total of 30 CRSwNP and CRSsNP patients with bilateral func- tional endoscopic sinus surgery and finished following up visit were randomly choosed, conventionally select the left nasal cavity as the experimental group, the right nasal cavity as the control group. Experimental group to pack the nasal cavity with pulmicort respu!es union nasopore after surgery and control group to pack the nasal cavity with only nasopore after surgery. The differences were observed in patients with subjective symptoms and recovery of mucosa of operative cavity between the two groups after two weeks, one month and three months. Result：①The postoperative VAS symptoms score about nasal obstruction, nasal secretion, headache, dizziness and distending pain after two weeks, one month and three months in the experiment group were significantly better than those in the control group（P〈0.05）.②The postoperative Lund-Kennedy endoscopic mucosa morphology score after two weeks, one month and three months in the experiment group were significantly better than those in the control group（P〈0.05）;③After three months, the experiment group had 28 cases with clinic symptoms cured（93.3%）, Total effective rate was 96.6%; The control group had 22 cases with clinic symptoms cured （73.3 % ）, total effective rate was 93.3 %. The cure rate of the experiment group was significantly higher than the control group（P〈0.05）, but there was no statistic difference between the two groups in the total effective rate （P〉0.05）. Conclusion：The application of nasal packing of pulmicort respules combined with nasopore after func- tional endoscopic sinus surgery can effectively relieve postoperative uncomfortable symptoms, promote recovery of mucosa of perative cavity, which deserves clinical oromotion.