碱性等渗盐水冲洗在慢性鼻窦炎鼻内镜术后患者中的应用效果

Effect of alkaline isotonic saline irrigation used in patients after nasal endoscopy for chronic sinusitis

目的:探讨碱性等渗盐水冲洗应用于慢性鼻窦炎鼻内镜术后患者的效果。方法:选择2022年4月-2023年10月行鼻内镜手术的慢性鼻窦炎患者95例,按照乱数表法分为观察组(n=48)和对照组(n=47)。对照组术后给予生理盐水冲洗,观察组术后给予碱性等渗盐水冲洗。观察两组术后恢复情况、鼻部功能[鼻腔容积(NCV)、鼻腔最小横截面积(NMCA)、鼻气道阻力(NAR)、嗅觉功能评分]、健康质量[鼻腔鼻窦结局20量表(SNOT-20)、鼻阻塞症状评估量表(NOSE)、视觉模拟量表(VAS)]及不良反应发生率。结果:与对照组比较,观察组鼻黏膜纤毛传输速率更快,纤毛清除率更高,鼻腔通气时间、鼻黏膜恢复时间更短,差异有统计学意义(P<0.05)。术前,两组NCV,NMCA,NAR,SNOT-20,NOSE,VAS及嗅觉功能评分比较,差异无统计学意义(P>0.05)。术后1个月,观察组NCV和NMCA高于对照组,NAR,SNOT-20,NOSE,VAS及嗅觉功能评分低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为4.17%,对照组为6.38%,两者比较,差异无统计学意义(P>0.05)。结论:与生理盐水鼻腔冲洗相比,使用碱性等渗盐水冲洗可促进慢性鼻窦炎鼻内镜术后患者术后恢复,改善鼻部功能和健康质量评分,且安全性良好。

Objective:To explore the effect of alkaline isotonic saline irrigation in patients after nasal endoscopy for chronic sinusitis.Methods:A total of 95 sinusitis patients who underwent endoscopic sinus surgery between April and October 2022 were 2023,according to the chaos table method divided into control group(n=47)and observation group(n=48).The control group patients after postoperative saline irrigation,observation group were given alkaline isotonic saline irrigation after surgery.Postoperative recovery,nasal function[nasal volume(NCV),minimum cross-sectional area(NMCA),nasal airway resistance(NAR),olfactory function score],health quality[nasal and sinus outcomes scale 20(SNOT-20),assessment scale of nasal obstruction symptoms(NOSE),visual analog scale(VAS)],incidence of adverse events were observed in both groups.Results:Compared with the control group,a faster nasal mucosal cilia transmission rate,higher cilia clearance rate,and shorter recovery time of nasal ventilation and nasal mucosa were observed in the observation group(P<0.05).Before surgery,the differences between NCV,NMCA,NAR,olfactory function score and SNOT-20,NOSE,and VAS scores were insignificant(P>0.05).One month after surgery,NCV and NMCA were significantly higher than the observation group,and NAR,olfactory function,SNOT-20,NOSE and VAS scores were significantly lower than the control group(P<0.05).The incidence of adverse events of 4.17%in the observation group and 6.38%in the control group was insignificant(P>0.05).Conclusion:Compared with normal saline nasal irrigation,the use of alkaline isotonic saline is more obvious on the postoperative recovery,nasal function and health quality of patients after chronic sinusitis,and has good safety.