内窥镜微创手术对鼻息肉患者切口感染发生及Eotaxin、Eotaxin-2表达的影响

Effect of Minimally Invasive Endoscopic Surgery on Wound Infection and Expression of Eotaxin and Eotaxin-2 in Patients with Nasal Polyps

目的探讨内窥镜微创手术在鼻息肉患者中的临床效果及对切口感染、嗜酸粒细胞趋化蛋白(Eotaxin)、嗜酸粒细胞趋化蛋白2(Eotaxin-2)的影响。方法选择2016年6月—2018年4月治疗的鼻窦炎鼻息肉患者72例作为对象,随机数字表法分为对照组(n=36)和观察组(n=36)。对照组采用传统鼻腔、鼻窦手术治疗,观察组采用鼻内镜手术治疗,两组术后3 d对患者效果进行评估,比较两组手术参数、炎症因子、Eotaxin、Eotaxin-2阳性率及术后切口感染率、复发率。结果观察组手术时间、术中出血量、住院时间及术中引流量,均少(短)于对照组(P<0.05)。观察组术后3 d的IL-5、IL-17水平,均低于对照组(P<0.05)。观察组手术后Eotaxin、Eotaxin-2阳性率,低于对照组(P<0.05)。免疫组化结果显示:观察组术后鼻息肉组织中嗜酸细胞数量减少,Eotaxin、Eotaxin-2表达水平较低,且多表达于黏膜上皮细胞、黏膜下炎性细胞中;对照组术后鼻息肉组织中嗜酸细胞数量较多,Eotaxin、Eotaxin-2表达水平较高;观察组术后切口感染、术后粘连、上颌窦开口狭窄发生率,低于对照组(P<0.05)。两组术后1个月复发率比较差异无统计学意义(P>0.05);观察组术后3个月、6个月复发率,均低于对照组(P<0.05)。结论内窥镜微创手术用于鼻息肉患者中手术创伤较小,能降低炎症因子水平,能降低Eotaxin、Eotaxin-2阳性率及术后切口感染率、复发率,值得推广应用。

Objective To investigate the clinical effect of minimally invasive endoscopic surgery in patients with nasal polyps and its influence on incision infection,eosinophil chemotactic protein(Eotaxin)and eosinophil chemotactic protein 2(Eotaxin-2).Methods 72 patients with sinusitis and nasal polyps treated from June 2016 to April 2018 were enrolled.They were divided into control group(n=36)and observation group(n=36)by random number table method.The control group was treated with traditional nasal cavity and sinus surgery.The observation group was treated with endoscopic surgery.The effect of the two groups was evaluated 3 days after operation.The surgical parameters,inflammatory factors,positive rate of Eotaxin and Eotaxin-2,postoperative incision infection rate and recurrence rate were compared between the two groups.Results The operation time,intraoperative blood loss,hospital stay and intraoperative drainage volume in the observation group were less(shorter)than those in the control group(P<0.05).The levels of IL-5 and IL-17 in the observation group were lower than those in the control group 3 days after surgery(P<0.05).The positive rate of Eotaxin and Eotaxin-2 in the observation group after operation was lower than that in the control group(P<0.05).The results of immunohistochemistry showed that the number of eosinophils in nasal polyps decreased after operation in the observation group,and the expression levels of Eotaxin and Eotaxin-2 were lower,and they were mostly expressed in mucosal epithelial cells and submucosal inflammatory cells.The number of eosinophils in nasal polyps was higher after operation in the control group,and the expression levels of Eotaxin and Eotaxin-2 were higher.The incidence of postoperative incision infection,postoperative adhesion,and maxillary sinus opening stenosis in the observation group was lower than that in the control group(P<0.05).There was no significant difference in the recurrence rate 1 month after operation between the two groups(P>0.05).The recurrence rate of the observation group at 3 months and 6 months after operation was lower than that of the control group(P<0.05).Conclusion Minimally invasive endoscopic surgery for nasal polyp patients has less surgical trauma,can reduce the level of inflammatory factors,and can reduce the positive rate of Eotaxin and Eotaxin-2,postoperative incision infection rate and recurrence rate,which is worthy of popularization and application.