曲安奈德鼻喷雾剂联合鼻内镜手术对慢性鼻窦炎伴鼻息肉患者VAS评分、鼻黏膜纤毛输送速率的影响

Effect of Triamcinolone Acetonide Nasal Spray Combined with Endoscopic Sinus Surgery on VAS Score and Nasal Mucociliary Transport Rate in Patients with Chronic Sinusitis and Nasal Polyps

目的研究曲安奈德鼻喷雾剂联合鼻内镜手术对慢性鼻窦炎伴鼻息肉患者VAS评分、鼻黏膜纤毛输送速率的影响。方法选取2022年1月-2023年1月在我院诊治的60例慢性鼻窦炎伴鼻息肉患者为研究对象,采用随机数字表法分为对照组和观察组,各组30例。对照组采用鼻内镜手术联合生理盐水治疗,观察组在对照组基础上联合曲安奈德鼻喷雾剂治疗。比较两组治疗效果、术后鼻腔清洁时间、疼痛(VAS)评分、鼻黏膜纤毛输送速率、嗅觉功能、鼻腔功能及不良反应发生情况。结果观察组治疗总有效率(96.67%)高于对照组(83.33%)(P<0.05);观察组术后鼻腔清洁时间、VAS评分均小于对照组,鼻黏膜纤毛输送速率高于对照组(P<0.05);两组治疗后嗅觉功能评分均低于治疗前,且观察组低于对照组(P<0.05);两组鼻气道总阻力(NAR)、鼻腔最小截面积至前鼻孔距离(DCAN)均小于治疗前,鼻腔容积(NCV)、鼻腔最小横截面积(NMCA)均高于治疗前,且观察组NAR、DCAN小于对照组,NCV、NMCA高于对照组(P<0.05);观察组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论曲安奈德鼻喷雾剂联合鼻内镜手术治疗慢性鼻窦炎伴鼻息肉效果确切,可提高治疗效果,降低疼痛,缩短鼻腔清洁时间,提升鼻黏膜纤毛输送速率,改善鼻腔和嗅觉功能,且不增加不良反应,值得临床应用。

Objective To study the effect of triamcinolone acetonide nasal spray combined with endoscopic sinus surgery on VAS score and nasal mucociliary transport rate in patients with chronic sinusitis and nasal polyps.Methods A total of 60 patients with chronic sinusitis and nasal polyps diagnosed and treated in our hospital from January 2022 to January 2023 were selected as the research objects.They were divided into control group and observation group by random number table method,with 30 patients in each group.The control group was treated with nasal endoscopic surgery combined with normal saline,and the observation group was treated with triamcinolone acetonide nasal spray on the basis of the control group.The therapeutic effect,postoperative nasal cleaning time,pain(VAS)score,nasal mucociliary transport rate,olfactory function,nasal function and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group(96.67%)was higher than that in the control group(83.33%)(P<0.05).The postoperative nasal cleaning time and VAS score of the observation group were less than those of the control group,and the nasal mucosal cilia transport rate was higher than that of the control group(P<0.05).The olfactory function score of the two groups after treatment was lower than that before treatment,and that of the observation group was lower than of the control group(P<0.05).The total nasal airway resistance(NAR)and the distance from the minimum cross-sectional area of the nasal cavity to the anterior nostril(DCAN)in the two groups were lower than those before treatment,and the nasal cavity volume(NCV)and the minimum cross-sectional area of the nasal cavity(NMCA)were higher than those before treatment,while the NAR and DCAN in the observation group were lower than those in the control group,and the NCV and NMCA were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusion Triamcinolone acetonide nasal spray combined with endoscopic sinus surgery is effective in the treatment of chronic sinusitis with nasal polyps,which can improve the therapeutic effect,reduce pain,shorten nasal cleaning time,improve nasal mucociliary transport rate,improve nasal cavity and olfactory function,and does not increase adverse reactions.It is worthy of clinical application.