布地奈德联合鼻内镜手术治疗鼻窦炎-鼻息肉疗效及对患者鼻腔功能的影响

Therapeutic effect of budesonide combined with endoscopic surgery on sinusitis-nasal polyps and its effect on nasal function

目的:研究布地奈德联合鼻内镜手术对鼻窦炎-鼻息肉的治疗效果及对患者鼻腔功能的影响。方法:纳入鼻窦炎-鼻息肉患者134例,随机分为对照组和观察组,各67例。两组患者均行鼻内镜手术,观察组在鼻内镜术后使用布地奈德进行喷鼻,对照组除不使用布地奈德进行喷鼻外,其余操作同观察组。对两组患者治疗前后临床症状改善评分、鼻黏膜结构、嗅觉功能、血清炎症因子水平以及术后复发率进行比较。结果:治疗后,对照组和观察组鼻塞、鼻漏和头痛评分均明显降低(P<0.05),其中观察组鼻塞、鼻漏和头痛评分明显低于对照组(P<0.05)。对照组术后1年复发率明显高于观察组(P<0.05)。治疗后对照组和观察组Lund-Mackey和Lund-Kennedy评分均明显降低(P<0.05),其中观察组明显低于对照组(P<0.05)。治疗后,对照组和观察组的嗅觉功能评分均明显降低(P<0.05),其中观察组明显低于对照组(P<0.05)。治疗后,对照组和观察组的IL-6、TNF-α以及IFN-γ水平均明显降低(P<0.05),其中观察组明显低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:布地奈德联合鼻内镜手术治疗鼻窦炎-鼻息肉,能够明显改善患者的临床症状评分,降低复发率,同时有助于患者鼻黏膜结构和嗅觉功能的改善,安全性好,值得在临床中进行推广应用。

Objective:To study the therapeutic effect of budesonide combined with endoscopic surgery on sinusitis-nasal polyps and its effect on nasal function.Methods:A total of 134 patients with sinusitis-nasal polyps admitted were randomly divided into the control group and the observation group,67 cases each.Nasal endoscopic surgery was performed in both groups.The observation group was treated with budesonide aerosol and the control group was sprayed without budesonide after treatment.The clinical symptom improvement score,nasal mucosa structure,olfactory function,serum inflammatory factor level before and after treatment and postoperative recurrence rate were compared.Results:After treatment,the scores of nasal obstruction,rhinorrhea and headache were significantly lower in both groups(P<0.05),and the observation group were significantly lower than the control group(P<0.05).The 1-year recurrence rate of the control group was significantly higher than that of the observation group(P<0.05).The Lund-Mackey and Lund-Kennedy scores of both groups were significantly lower after treatment(P<0.05),and the observation group was significantly lower than the control group(P<0.05).After treatment,the olfactory function scores of the control group and the observation group were significantly lower(P<0.05),and the observation group was significantly lower than the control group(P<0.05).After treatment,the levels of IL-6,TNF-αand IFN-γin both groups were significantly lower(P<0.05),and the observation group was significantly lower than the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Budesonide combined with endoscopic surgery for sinusitis-nose polyps can significantly improve the clinical symptom score,reduce the recurrence rate,improve the structure of the na sal mucosa and olfactory function.It is safe and worth promoting and applying.