鼻内镜手术与糖皮质激素联合治疗慢性鼻—鼻窦炎患者的疗效研究

A study on the efficacy of combined endoscopic sinus surgery and glucocorticoid in the treatment of patients with chronic rhinosinusitis

目的探讨鼻内镜手术与糖皮质激素联合治疗慢性鼻—鼻窦炎患者的疗效。方法选择濮阳市油田总医院耳鼻咽喉科2017年5月—2019年5月进行治疗的慢性鼻—鼻窦炎患者共110例,随机分为对照组和观察组,每组患者为55例。对照组采用鼻内镜手术治疗。观察组在对照组的基础上联合糖皮质激素进行治疗。治疗后随访1年,比较治疗前后鼻气道阻力、嗅觉功能评分情况及术后不良反应发生情况。结果治疗后分别随访6个月、1年,观察组患者鼻气道阻力小于对照组,嗅觉功能评分高于对照组(P<0.05);观察组治疗后鼻腔粘连、脑脊液鼻漏和眶周淤血、过敏及眶骨膜下脓肿发生率均低于对照组(P<0.05)。结论鼻内镜手术联合糖皮质激素治疗慢性鼻—鼻窦炎患者效果显著,可有效减小鼻气道阻力,改善患者嗅觉功能,降低术后不良反应发生率,安全性较高,值得在临床中推广应用。

Objective:To investigate the efficacy of combined treatment of chronic rhinosinusitis with nasal endoscopic surgery and glucocorticoids.Methods:A total of 110 patients with chronic rhinosinusitis who were treated in our department from May 2017 to May 2019 were selected and randomly divided into control group and observation group,with 55 patients in each group.The control group was treated with endoscopic sinus surgery.The observation group was treated with glucocorticoid on the basis of the control group.The patients were followed up for 1 year after treatment,and the nasal airway resistance,olfactory function scores and postoperative adverse reactions were compared before and after treatment.Results:Follow-up for 6 months and 1 year respectively after treatment.The observation group had lower nasal airway resistance than the control group,and the olfactory function score was higher than that of the control group(P<0.05);the observation group had nasal adhesions,cerebrospinal fluid rhinorrhea and periorbital after treatment The incidence of congestion,allergies and orbital subperiosteal abscess were lower than those of the control group(P<0.05).Conclusion:Endoscopic sinus surgery combined with glucocorticoids is effective in the treatment of patients with chronic rhinosinusitis.It can effectively reduce nasal airway resistance,improve the patient’s olfactory function,and reduce the incidence of postoperative adverse reactions.It has high safety and is worth clinically.Promotion and application.