鼻内镜术后微波热凝联合呋塞米局部应用临床研究

Clinical Study of Microwave Thermocoagulation Combined with Local Application of Furosemide for Treating Patients After Nasal Endoscopic Surgery

目的探讨微波热凝联合局部应用呋塞米对鼻内镜术后术腔病变组织的临床疗效。方法选择鼻内镜术后患者60例,按照性别、年龄匹配后随机分为3组,其中治疗组20例(微波热凝+呋塞米)、对照组20例(钳除法)、空白组20例(予生理盐水)。观察各组好转率、术腔上皮化时间、平均换药时间、换药次数、有无再一次填塞止血,并采用糖精试验法检测各组鼻内镜术前、术后2周、术后1个月、术后3个月的中鼻道纤毛输送速度。结果治疗组好转率为95.00%,对照组为75.00%,空白组为55.00%,治疗组与对照组比较,对照组与空白组比较无明显差异(P>0.05),治疗组与空白组比较差异有统计学意义(P<0.05);6个月内上皮化率,治疗组为100.00%,对照组为80.00%,空白组为40.00%,3组比较差异有统计学意义(P<0.05);3组患者术前鼻黏膜纤毛输送速率比较无统计学差异(P>0.05);术后2周、1个月及3个月,治疗组、对照组鼻黏膜纤毛输送速率显著高于空白组(P<0.05),且治疗组鼻黏膜纤毛输送速率显著高于对照组(P<0.05)。结论鼻内镜术后患者应用微波热凝联合局部应用呋塞米处理术腔能提高治愈率,提高上皮化率,缩短治疗时间,有利于为患者减轻痛苦,值得临床推广。

Objective To investigate the clinical effect of microwave thermocoagulation combined with local application of furosemide for treating pathosis organizationin nasal cavity after nasal endoscopic surgery. Methods Totally 60 patients after nasal endoscopic surgery were randomly divided into three groups according to age and gender, 20 cases in the treatment group （ treated with microwave thermo-coagulation and furosemide ） , 20 cases in the control group （ treated with forceps ） and 20 cases in the blank group （ treated with normal saline ） . The improvement rate, the time of cavity epithelization, the average dressing change time, frequency of dressing change and once again filling hemostasis were observed. The mucociliary transport rate of nasal meatus in each group was measured before operation and 2 weeks, 1 month, 3 months after operation by saccharin test. Results The improvement rate showed no significant difference between the treatment group and the control group （ 95. 00% vs 75. 00%, P 〉 0. 05 ） , and also showed no significant difference between the control group and the blank group （ 75. 00% vs 55. 00%, P 〉 0. 05 ） , but showed significant difference between the treatment group and the blank group （ 95. 00% vs 55. 00%, P 〈 0. 05 ） . Within 6 months, the epithelization rates in the treatment group, the control group and the blank group were 100. 00%, 80. 00% and 40. 00%, respectively, the differences among the 3 groups were statistically significant （ P 〈 0. 05 ） . The nasal mucociliary transport rate showed no significant difference among the three groups before operation （ P 〉 0. 05 ） . 2 weeks, 1 month and 3 months after operation, the nasal mucociliary transport rates of the treatment group and the con-trol group were significantly higher than that of the blank group （ P 〈 0. 05 ） , and the nasal mucociliary transport rate of the treatment group was significantly higher than that of the control group （ P 〈 0. 05 ） . Conclusion After nasal endoscopic surgery, microwave thermo-coagulation combined with local application of furosemide for treating patients can improve the cure rate and epithelialization rate, and shorten the treatment time, it is helpful to alleviate the pain of patients and worthy of clinical promotion.