慢性鼻鼻窦炎功能性鼻内镜术后不同冲洗液处理对复发情况的影响

Effects of Different Irrigations on the Recurrence of Chronic Rhinosinusitis after Functional Endoscopic Sinus Surgery

目的探究慢性鼻鼻窦炎功能性鼻内镜术后不同冲洗液处理对复发情况的影响。方法将2015年4月至2016年4月于我院择期行功能性鼻内镜手术的66例慢性鼻鼻窦炎患者采用随机数字表法分为两组。两组患者均于功能性鼻内镜术后进行术腔冲洗治疗。对照组给予500m L生理盐水冲洗术腔,观察组以10mg地塞米松+500m L生理盐水进行冲洗。比较两组冲洗治疗前、治疗2周及4周后的主要症状、体征评分;比较两组治疗总有效率;且均对两组随访3个月,观察两组患者复发率。结果观察组冲洗治疗2周、4周后症状评分(3.24±1.28)分、(2.13±1.15)分和体征评分(4.02±1.19)分、(3.42±0.96)分较治疗前及对照组冲洗治疗后2周、4周后症状评分(4.36±1.14)分、(3.57±1.27)分和体征评分(4.83±1.22)分、(4.02±0.85)分显著较低,差异有统计学意义(P<0.05)。观察组治疗总有效率90.91%高于对照组69.70%,复发率15.15%低于对照组42.42%,差异有统计学意义(P<0.05)。结论对慢性鼻鼻窦炎功能性鼻内镜术后患者给予术后冲洗鼻腔治疗,可显著改善患者的临床症状、体征,降低其复发率;地塞米松和生理盐水制成的冲洗液效果更佳。

Objective To study effects of different irrigations endoscopic sinus surgery. Methods From Apr. 2015 in our hospital were taken as the clinical research and observation group. Both groups accepted nasal on the recurrence of chronic rhinosinusitis after functional to Apr. 2016, a total of 66 patients with chronic rhinosinusitis objects, and they were randomly divided into control group irrigation treatment by 500mL normal saline after functional endoscopic sinus surgery, besides, the observation group was given additional 10mg dexamethasone. The main symptoms and signs were compared between the two groups before treatment, 2 and 4 weeks after treatment; the total effective rates of the two groups were also compared; and the recurrence rates of the two groups were observed after 3 months follow up. Results 2 and 4 weeks after treatment, the scores of symptoms in the observation group were respectively （3.24±1.28） and （2.13±1.15） which were not only lower than those in the control group （4.36±1.14） and （3.57±1.27）, but also lower than before treatment, and their differences were statistically significant （P〈0.05）, the scores of signs in the observation group were respectively （4.02± 1.19） and （3.42±0.96） which were not only lower than those in the control group （4.83±1.22） and （4.02±0.85）, but also lower than before treatment, and their differences were statistically significant （P〈0.05）. The total effective rate in the observation group was 90.91% which was higher than that in the control group 69.70%, and the recurrence rate in the observation group was 15.15% which was lower than that in the control group 42.42%, and their differences were statistically significant （P〈0.05）. Conclusion： Nasal irrigation treatment after functional endoscopic sinus surgery for chronic rhinosinusitis can obviously improve patients＇ clinical symptoms and signs and reduce recurrence rate, and the irrigation of dexamethasone and normal saline has better effect.