两种鼻腔冲洗方法在功能性鼻窦内镜手术后的效果比较

Effects comparison of two methods of nasal irrigation after functional endoscopic sinus surgery

目的观察并比较两种鼻腔冲洗方法在功能性鼻窦内镜手术后的应用效果。方法选择2012年4月-2014年4月于杭州市萧山区第一人民医院耳鼻喉科行鼻窦内镜下手术治疗的慢性鼻窦炎患者132例,所有患者均给予鼻内镜下Messerklinger术。采用随机数字表法将其分为对照组和观察组,每组各66例。术后给予两组不同的冲洗液,对照组为0.9%氯化钠溶液。观察组为0.9%氯化钠溶液200 mL混合庆大霉素16万U＋α-糜蛋白酶8000 U＋地塞米松10 mg。所有患者均随访超过3个月,观察比较两组患者的治疗效果。结果观察组治愈41例,治愈率为62.12%,对照组治愈29例,治愈率为43.94%,观察组治愈率明显高于对照组,差异有统计学意义（χ^2=24.842,P〈0.05）。观察组总有效率为95.45%,对照组总有效率为89.39%,观察组治疗总有效率明显高于对照组,差异有统计学意义（χ^2=12.782,P〈0.05）。结论功能性鼻窦内镜手术治疗慢性鼻窦炎后给予鼻腔冲洗能有效控制并发症的发生,安全性高,患者易于耐受且操作简便。庆大霉素、α-糜蛋白酶和地塞米松的氯化钠溶液冲洗效果优于单纯氯化钠溶液冲洗,值得临床推广。

Objective To compare the effects of two methods of nasal douche applied after functional endoscopic sinus surgery. Methods 132 cases of patients with chronic nasosinusitis had functional endoscopic sinus surgery in E.N.T.Department of the First People＇s Hospital of Xiaoshan District in Hangzhou City from April 2012 to April 2014 were selected, all the patients were given Messerklinger surgery under endoscopic sinus, and they were divided into two groups by random number table, control group and observation group, with 66 cases in each groups. Patients in the two groups were given different postoperative rinses, patients of the control group were given 0.9% sodium chloride solution,while patients in the observation group were given 0.9% sodium chloride solution combined with 160000 U gentamicin,8000 U α-chymotrypsin and 10 mg dexamethasone. All the patients were followed up more than 3 months, and the therapeutic effects of two groups were observed and compared. Results 41 cases in observation group were healed, cure rate was 62.12%, and 29 cases in control group were healed, cure rate was 43.94%, the cure rate in observation group was higher than that in the control group, the difference was statistically significant（χ^2=24.842, P〈 0.05）. The total effective rate in the observation group was 95.45%, while 89.39% in the control group, and the total effective rate in the observation group was higher than that in the control group, the difference was statistically significant（χ^2=12.782, P 〈0.05）. Conclusion It is effective to control complication by giving nasal douche after functional endoscopic sinus surgery, safe, tolerant and easy. The effect of sodium chloride solution combined with gentamicin, α-chymotrypsin and dexamethasone is better than that of sodium chloride solution alone. It is worthy of clinical promotion.