内窥镜微创手术配合糖皮质激素药物治疗慢性鼻窦炎的疗效观察

Observation on Efficacy of Minimally Invasive Endoscopic Surgery Combined with Glucocorticoids in the Treatment of Chronic Sinusitis

目的:观察内窥镜微创手术配合糖皮质激素药物治疗慢性鼻窦炎的疗效。方法:选取2015年8月—2016年6月我院收治的92例慢性鼻窦炎患者为研究对象,按随机数字表法分为对照组和研究组,各46例。对照组采用内窥镜微创手术治疗,研究组在对照组基础上加用糖皮质激素药物治疗:术前1周口服泼尼松(20 mg,bid);术后第2 d口服泼尼松(初始剂量24 mg,每周减去8 mg,直至每日8 mg);术后使用布地奈德喷剂实施吸入治疗,100μg/d。比较两组临床疗效以及并发症发生率。结果:研究组临床总有效率为93.48%高于对照组的71.74%,差异有统计学意义(P<0.05);研究组并发症发生率为6.52%低于对照组的26.09%,差异有统计学意义(P<0.05)。结论:采用内窥镜微创手术配合糖皮质激素药物治疗慢性鼻窦炎,可显著提高临床疗效,减少并发症发生率,值得临床推广。

Objective: To observe the efficacy of minimally invasive endoscopic surgery combined with glucocorticoids in the treatment of chronic sinusitis. Methods: A total of 92 patients with chronic sinusitis who were enrolled in our hospital from August 2015 to June 2016 were selected as subjects and divided into control group and study group according to the random number table method, 46 cases in each group. The patients in the control group were treated by minimally invasive endoscopic surgery, and the patients in the study group were further treated with glucocorticoids by orally taking prednisone one week before operation(20 mg, bid), orally taking prednisone on the second day after operation(initial dose 24 mg, decreasing 8 mg per week till dose was 8 mg), using budesonide spray after operation for inhalation therapy at 100 μg/d. The clinical efficacy and the incidence of complications were compared between the two groups. Results: The total effective rate in the study group was 93.48%(43/46), which was significantly higher than that in the control group(71.74%, 33/46), and the difference was statistically significant(P<0.05); the incidence of complications in the study group was 6.52%(3/46), which was significantly lower than that in the control group(26.09%, 12/46), and the difference was statistically significant(P<0.05). Conclusion: Minimally invasive endoscopic surgery combined with glucocorticoid in the treatment of chronic sinusitis can significantly improve clinical efficacy and reduce the incidence of complications, and is worthy of clinical promotion.