倍氯米松喃鼻引起鼻中隔穿孔临床分析

Clinical analysis of nasoseptal perforation caused by beclometasone nasal spray

目的:对临床应用倍氯米松鼻喷雾剂(伯克纳)引起鼻中隔穿孔患者进行追踪观察,分析诱发因素,提出预防措施。方法:对1996～1999年应用本品2支以上的178例住院患者,应用鼻窥镜连续追踪观察3～6个月,对鼻中隔病变过程进行临床分析研究。结果:在178例中,鼻中隔粘膜明显缺血12例(6.74％),鼻中隔粘膜变薄6例(3.37％)鼻中隔粘膜缺损3例(1.69％),鼻中隔穿孔5例(2.81％)。结论:严格按照本品说明书操作,并在喷鼻时改变持瓶方法;鼻中隔偏曲矫正术前后慎用或禁用本品;凡连续应用本品者,应每月进行鼻中隔检查,以预防鼻中隔穿孔。

Objective: To make a follow-up observation of patients with nasoseptal perforation caused by beclometa-sone nasal spray, and put forward preventive measures. Methods: 178 cases of inpatients having applied more than 2 canisters of the drug from 1996 to 1999 were continually observe with rhinoscope for 3~6 months, and the pathological process of the nasal septum was clinically analyzed. Results: In the 178 cases, there were 12 cases (6.74% ) of mucosal ischemia of the nasal septum, 6 cases (3.37%) of thinned mucosa of nasal septum, 3 cases (1.69% ) of nasal septum mucosal defect, and 5 cases (2.81 % ) of nasal septum perforation. Conclusion: Operate strictly in accordance with the directions, and change the methods for holding the canister to spray the drug into nose; the drug is contraindicated or used with great care for patients before or after nasal septum correction is performed; monthly examination of nasal septum is necessary to prevent perforation for patients using the drug continually.