鼻内镜手术联合药物治疗慢性鼻窦炎伴鼻息肉的临床效果分析

Clinical Effect Analysis of Nasal Endoscopic Surgery Combined with Drugs in the Treatment of Chronic Rhinosinusitis with Nasal Polyps

目的探讨鼻内镜手术联合药物治疗慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyp,CRSwNP)的临床效果。方法选取2021年1月—2023年1月南通市通州区人民医院耳鼻咽喉科门诊及病房收治的80例CRSwNP患者为研究对象,采用随机数表法分成对照组和研究组,每组40例。其中对照组给予单纯鼻内镜手术治疗,研究组在对照组的基础上增加给予布地奈德鼻喷雾剂局部治疗。比较两组临床疗效、嗅觉功能、鼻腔功能以及术后复发、并发症发生情况。结果治疗后两组总有效率比较,差异无统计学意义(χ^(2)=0.206,P=0.650)。治疗前两组嗅觉功能分级比较,差异无统计学意义(P>0.05);治疗后两组嗅觉功能分级比较,差异无统计学意义(P>0.05)。治疗后两组鼻腔最小横截面至前鼻孔距离、鼻腔最小横截面积、鼻腔容积均优于治疗前,差异有统计学意义(P<0.05);且研究组3项指标均优于对照组,差异有统计学意义(P<0.05)。研究组6个月内的复发率为2.50%,低于对照组的12.50%,差异有统计学意义(χ^(2)=6.537,P=0.011)。两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论鼻内镜手术联合布地奈德局部治疗CRSwNP能够改善患者术后鼻腔通气功能、降低术后复发率,效果确切。

Objective To investigate the clinical effect of nasal endoscopic surgery combined with drug treatment for chronic rhinosinusitis with nasal polyp(CRSwNP).Methods From January 2021 to January 2023,80 patients with CRSwNP admitted to the outpatient and ward of the Department of Otorhinolaryngology,Nantong Tongzhou District People's Hospital were selected as the research objects.They were divided into control group and study group by random number table method,with 40 cases in each group.The control group was treated with simple nasal endoscopic surgery,and the study group was treated with budesonide nasal spray on the basis of the control group.The clinical efficacy,olfactory function,nasal function,postoperative recurrence and complications were compared between the two groups.Results There was no statistically significant difference in the total effective rate between the two groups after treatment(χ^(2)=0.206,P=0.650).There was no statistically significant difference in olfactory function grading between the two groups before treatment(P>0.05).There was no statistically significant difference in olfactory function grading between the two groups after treatment(P>0.05).After treatment,the distance from the minimum cross-section of the nasal cavity to the anterior nostril,the minimum cross-sectional area of the nasal cavity,and the nasal cavity volume of the two groups were better than those before treatment,and the differences were statistically significant(P<0.05).The three indexes of the study group were better than those of the control group,and the difference was statistically significant(P<0.05).The recurrence rate within 6 months in the study group was 2.50%,which was lower than 12.50%in the control group,and the difference was statistically significant(χ^(2)=6.537,P=0.011).There was no statistically significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion Nasal endoscopic surgery combined with topical budesonide in the treatment of CRSwNP can improve the patients'postoperative nasal ventilation function and reduce the postoperative recurrence rate,the effect is accurate.