鼻内镜下鼻窦开放术后鼻腔处理方法分析

Analysis of nasal cavity treatment after intranasal endoscopic sinuses open surgery

目的探讨鼻内镜下鼻窦开放术后,鼻腔检查及清理的有效方法。方法随机选取2015年1月-2016年12月在昆山市第一人民医院鼻内镜下行鼻窦开放术患者50例,分为对照组与观察组各25例,术后均进行鼻内鼻腔黏膜检查及药物治疗,并利用糖精清除率法测定患者鼻腔黏膜的纤毛清除功能,两组患者均在鼻内镜下清理术腔,给予布地奈德鼻喷剂及抗炎治疗,观察组在此基础上进一步使用球囊鼻腔冲洗器进行术腔冲洗,比较两组患者的治愈情况与鼻腔纤毛功能。结果观察组患者的治愈率为92.0%,显著高于对照组的80.0%,且鼻腔黏膜上皮皮化所需时间为(46.7±5.36)d,明显短于对照组患者(62.3±4.97)d,差异均有统计学意义(P<0.05)。结论鼻窦开放术后鼻内镜下术腔处理及药物治疗结合鼻腔冲洗可提高手术治愈率,减少术后复发。

Objective To investigate the nasal cavity examination and effective cleaning method after intranasal endoscopic sinuses open surgery. Methods 50 patients with intranasal endoscopic sinuses open surgery from January 2015 to December 2016 in the First People＇s Hospital of Kunshan were selected and divided into the control group and the observation group with 25 cases in each group. After surgery,the nasal cavity mucosa were examined and given drug treatment. The mucociliary clearance function of nasal mucosa was determined by saccharin clearance method. Two groups of patients were cleaned the cavity under nasal endoscopic and given budesonide nasal spray and anti-inflammatory treatment. The observation group was further treated with balloon nasal irrigation for intraoperative lavage on this basis.The curative effect and nasal mucociliary function of the two groups were compared. Results The cure rate was 92.0% in the observation group,which was significantly higher than that of the control group with 80.0%,and the time required for nasal mucosal epithelialization was（46.7±5.36） d,which was significantly shorter than that in the control group with（62.3 ±4.97） d. The differences were statistically significant（P〈0.05）. Conclusion After open sinus surgery,cleaning the cavity under nasal endoscopic and drug treatment combined with nasal irrigation can improve the surgical cure rate and reduce postoperative recurrence.