甲泼尼龙与氢化泼尼松在慢性鼻-鼻窦炎合并鼻息肉患者鼻内镜术后的应用

Application of methylprednisolone and hydroprednisone in patients with chronic rhinitis-rhinosinusitiscomplicated withnasal polypsthose received nasal endoscopic surgery

目的探究慢性鼻-鼻窦炎并发鼻息肉患者实施鼻内镜术后加以甲泼尼龙与氢化泼尼松药物治疗的效果及对鼻黏膜功能的影响.方法选择2017年5月—2019年5月本院收治的80例实施鼻内镜术的慢性鼻-鼻窦炎合并鼻息肉患者作为研究对象,采用随机数表法分为A组与B组两组,每组各40例.均于术后立即行药物治疗,其中A组予甲泼尼龙,B组予氢化泼尼松,比较两组治疗前及治疗两个月后的鼻窦炎相关症状严重程度、疼痛不适程度、鼻内镜下评分及鼻黏膜纤毛功能,治疗6个月后的复发情况及并发症发生率.结果A组患者的美国鼻腔鼻窦结局测量20条(SNOT-20)评分、视觉模拟评分(VAS)评分及鼻内镜Lund-Kennedy评分均较B组患者显著降低(P<0.05);A组患者的纤毛细胞数目/杯状细胞数目比值较B组显著增大,其鼻腔内黏膜纤维的传输速率(MTR)较B组显著增快(P<0.05);A组患者的总并发症发生率显著低于B组患者(P<0.05);A组患者6个月后复发率较B组显著低(P<0.05).结论甲泼尼龙应用于慢性鼻-鼻窦炎并发鼻息肉患者鼻内镜术后的效果优于使用氢化泼尼松,可更有效地改善鼻黏膜功能,促进患者康复,预后更佳且安全性更高.

Objective To explore the curative effect of methylprednisolone and hydroprednisone on patients with chronic rhinitis-rhinosinusitis complicated with nasal polyps those received nasal endoscopic surgery and its influence on nasal mucosa function.Methods Eighty patients with chronic rhinitis-rhinosinusitis complicated with nasal polyps those underwent nasal endoscopic surgery in the hospital from May 2017 to May 2019 were enrolled in the study.They were divided into group A and group Baccording to the random number table method,40 cases in each group.All patients were treated with drugs immediately after surgery.Patients in group A were treated with methylprednisolone,while those in group B were treated with hydroprednisone.The severity of rhinosinusitis-related symptoms,degree of pain and discomfort,nasal endoscopic scores and nasal mucosa cilia function before treatment and after 2 months of treatment,recurrence and incidence of complications half a year after treatment were compared between the two groups.Results Scores of the 20-Item Sino-Nasal Outcome test(SNOT-20),Visual Analogue Scale(VAS)and nasal endoscopic LundKennedy in group A were significantly lower than those in group B(P<0.05).The number of ciliated cell/number of goblet cell ratio in group A was significantly larger than that in group B,and the mucociliary transport rate(MTR)was significantly faster than that in group B(P<0.05).The total incidence of complications and 6-month recurrence rate in group A were significantly lower than thosein group B(P<0.05).Conclusions The curative effect of methylprednisolone is better than that of hydroprednisone in the treatment of patients with chronicrhinitis-rhinosinusitis complicated with nasal polyps those received nasal endoscopic surgery.The former could effectively improve the nasal mucosa functionof patients,promote their recovery,presentsbetter prognosis and higher safety.