鼻内镜下中鼻甲成形术后联合布地奈德浸润治疗在鼻窦炎伴鼻息肉患者中的应用效果

Application effect of endoscopic middle turbinate plasty combined with budesonide infiltration therapy in patients with sinusitis and nasal polyps

目的探讨鼻内镜下中鼻甲成形术后联合布地奈德浸润治疗在鼻窦炎伴鼻息肉患者中的应用效果。方法选取2018年1月至2019年9月收治的88例鼻窦炎伴鼻息肉患者作为研究对象,采用随机数字表法将其分为对照组与观察组,各44例。对照组给予鼻内镜下中鼻甲成形术+术后常规鼻腔冲洗及清理,观察组在对照组基础上给予术后布地奈德浸润治疗。比较两组的鼻腔气流指标、T-bet、GATA-3表达情况及复发率。结果治疗后,两组的鼻气道阻力、鼻腔最小横截面至前鼻孔的距离(DCAN)均减小,鼻腔容积(NCV)、鼻腔最小横截面积(NMCA)均增大,且观察组优于对照组(P<0.05)。治疗后,两组的T-bet、GATA-3阳性细胞数均减少,且观察组少于对照组(P<0.05)。随访12个月,观察组的复发率为4.55%,低于对照组的22.73%(P<0.05)。结论鼻内镜下中鼻甲成形术后联合布地奈德浸润治疗可改善鼻窦炎伴鼻息肉患者的鼻腔气流,减少T-bet、GATA-3阳性细胞,控制复发率。

Objective To explore the application effect of endoscopic middle turbinate plasty combined with budesonide infiltration therapy in patients with sinusitis and nasal polyps.Methods Eighty-eight patients with sinusitis and nasal polyps treated from January 2018 to September 2019 were selected as the research objects and divided into control group and observation group according to random number table method,with 44 cases in each group.The control group was given endoscopic middle turbinate plasty+postoperative routine nasal flushing and cleaning,and the observation group was given postoperative budesonide infiltration therapy on the basis of the control group.The nasal airflow indexes,the expression of T-bet and GATA-3 and the recurrence rate were compared between the two groups.Results After treatment,nasal airway resistance and the distance from the minimum cross section of the nasal cavity to the anterior nostril(DCAN)decreased in both groups,nasal cavity volume(NCV)and nasal minimal cross-sectional area(NMCA)increased,and those in the observation group were better than the control group(P<0.05).After treatment,the number of T-bet and GATA-3 positive cells decreased in both groups,and those in the observation group were less than the control group(P<0.05).After 12 months of follow-up,the recurrence rate in the observation group was 4.55%,which was lower than 22.73%in the control group(P<0.05).Conclusion Endoscopic middle turbinate plasty combined with budesonide infiltration therapy can improve nasal airflow,reduce T-bet and GATA-3 positive cells and control the recurrence rate in patients with sinusitis and nasal polyps.