慢性鼻-鼻窦炎综合治疗的临床分析

Analysis of efficacy of comprehensive treatment in patients with chronic sinusitises

目的评估以中性粒细胞浸润为主和以嗜酸性粒细胞浸润为主的两种病理学特征的慢性鼻-鼻窦炎综合治疗的临床效果。方法选取经住院手术治疗后症状未得到改善、术后3个月视觉模拟量表(VAS)主观症状评分>6分的慢性鼻窦炎患者256例。根据细胞浸润类型给予不同的综合治疗方案,观察治疗后患者VAS主观症状评分、Lund-Kennedy内镜评分及鼻组织病理学检查的改善情况。结果综合治疗后,以嗜酸性粒细胞浸润为主的患者主观症状及鼻内镜检查有明显改善,鼻组织嗜酸性粒细胞的数目未见明显减少;以中性粒细胞浸润为主的患者主观症状及鼻内镜检查均得到明显改善,中性粒细胞数降低。结论根据不同的免疫病理学特征,慢性鼻窦炎的患者要给予不同的治疗方案,以中性粒细胞浸润为主的疗效明显。

Objective To assess clinical efficacy of comprehensive treatment on chronic sinusitises （CRS） with neutro-phils infiltration and eosinophilic infiltration as pathological features. Methods A total of 256 CRS patients whose symp-toms were not been improved after surgery （visual analog scale〉6,3 months after surgery） were included in this study. Dif-ferent comprehensive treatments were given to the patients according to the different types of cell infiltration. The visual ana-log scale （VAS）, Lund-Kennedy and nasal histopathological examination were observed after treatment in patients. Results After different comprehensive treatments, the VAS and Lund-Kennedy were improved in patients with eosinophils infiltra-tion, but the number of eosinophils was not reduced. The VAS, Lund-Kennedy and the number of neutrophils were signifi-cantly improved in patients with mainly neutrophils infiltration. Conclusion According to different immune pathological characteristics, patients of CRS should be given different comprehensive treatments. There is a obvious efficacy for patients with neutrophil infiltration.