鼻内镜术后高渗盐水联合抗生素鼻腔冲洗治疗变应性真菌性鼻窦炎疗效及对患者生活质量影响分析

The effect of hypertonic saline combined with antibiotic nasal irrigation after endoscopic surgery for the treatment of allergic fungal sinusitis and its influence on the patient's life quality

目的:探讨鼻内镜术后高渗盐水联合抗生素鼻腔冲洗治疗变应性真菌性鼻窦炎(AFS)的疗效及对患者生活质量的影响。方法:将入选的120例AFS均分为两组,两组患者均实行鼻内镜手术联合术后鼻腔冲洗治疗,而对照组所用冲洗液为1000ml 3%高渗盐水;而试验组冲洗液为1000ml 3%高渗盐水+10mg地塞米松+16万U庆大霉素+8000Uα-糜蛋白酶。术后随访1年,观察两组病情控制情况、术后1、6、12个月鼻腔纤毛传输速度;对比两组术前及术后1、6、12个月Lund-Mackay鼻内镜及VAS评分;评价两组术前及术后12个月生活质量。结果:术后随访,试验组临床完全控制率85.00%,总有效率为96.67%;均明显高于对照组(70.00%,86.67%)(P<0.05)。术后随恢复时间延长,两组鼻腔纤毛传输速度均明显加快,Lund-Mackay鼻内镜CT评分及VAS评分均逐渐下降(P<0.05);且与对照组比,试验组术后鼻腔纤毛传输速度均加快更明显,Lund-Mackay鼻内镜CT评分及VAS评分降低更明显(P<0.05)。术后经1年时间恢复,两组在生理问题、情感问题及功能限制方面生活质量评分均明显降低(P<0.05),且试验组各方面下降更明显(P<0.05)。结论:鼻内镜术后选择3%高渗盐溶液+抗生素类冲洗液进行鼻腔冲洗,可有效促进临床症状消退,加速鼻腔黏膜上皮化,缩短病程,提高患者生存质量,效果显著。

Objective:To investigate the effect of hypertonic saline combined with antibiotic nasal irrigation after endoscopic surgery in the treatment of allergic fungal sinusitis(AFS)and its influence on the quality of life of patients.Methods:120 AFS patients were divided into two groups,and Both groups of patients underwent endoscopic surgery and postoperative nasal irrigation to treatment.In the control group,1000 ml of 3%hypertonic saline was used as the rinsing solution,and 1000 ml of 3%hypertonic saline+10 mg dexamethasone+160,000 U gentamicin+8000 U alpha-chymotrypsin was used as the irrigating solution in the test group.After one year follow-up,the condition of the two groups was observed,and the nasal cilia transfer velocity at 1,6,and 12 months after operation was observed.The Lund-Mackay endoscopic and VAS scores were compared between the two groups before operation and 1,6,and 12 months after operation.The quality of life before and 12 months after surgery in both groups was evaluated.Results:After follow-up,the complete clinical control rate of the experimental group was 85.00%,and the total effective rate was 96.67%;both were significantly higher than the control group(70.00%,86.67%)(P<0.05).Postoperatively,with the prolonged recovery time,the transmission rate of nasal cilia was significantly increased in both groups,Lund-Mackay's endoscopic CT and VAS scores were gradually decreased(P<0.05);and compared with the control group,the nasal cavity cilia transmission rate in the experimental group was faster and more obvious,Lund-Mackay endoscopic CT and VAS scores reduced more obvious(P<0.05).After 1 year of recovery,the quality of life scores of the two groups were significantly reduced in terms of physiological problems,emotional problems and functional limitations(P<0.05),and the decline was more obvious in all aspects of the experi mentalgroup(P<0.05).Conclusion:Nasal endoscopic selection of 3%hypertonic saline solution+antibiotic wash for nasal irrigation,can effectively promote the regression of clinical symptoms,accelerate nasal mucosal epithelization,shorten the course of the disease and improve the quality of life of patients,the effect is significant.