鼻腔雾化吸入布地奈德混悬液治疗鼻内镜术后迁延性鼻-鼻窦炎  

Clinical effect of inhalation of budesonide suspension on persistent rhino-sinusitis following endoscopic sinus surgery

作　　者：刘玉和[1] 王全桂[1] 沈泓[1] 吴园丁[1] 王军[1] 

机构地区：[1]北京大学第一医院耳鼻咽喉头颈外科,北京100034

出　　处：《中国新药杂志》2008年第8期688-690,692,共4页Chinese Journal of New Drugs

摘　　要：目的:探讨吸入布地奈德混悬液(普米克令舒)鼻内雾化用药对慢性鼻窦炎鼻内镜术后迁延性鼻-鼻窦炎的治疗效果,为鼻内镜术后迁延性鼻-鼻窦炎处理提供依据。方法:对362例慢性鼻窦炎鼻内镜术后常规鼻内镜下术腔护理后仍存在迁延性鼻-鼻窦炎的16例患者,行糖皮质激素普米克令舒连续鼻内雾化16 d,结合鼻-鼻窦冲洗和抗生素治疗,观察临床疗效。结果:16例迁延性鼻-鼻窦炎术前均为II或III型慢性鼻窦炎,并伴有变应性鼻炎,术后鼻内镜下术腔护理超过3个月,经普米克令舒鼻内雾化结合其他治疗后,鼻塞、头痛、流脓涕症状消失,变应性鼻炎症状得到控制,鼻腔、鼻窦黏膜水肿渐消退,术腔上皮化,各窦口引流通畅,随访无复发。结论:慢性鼻窦炎鼻内镜术后的鼻内镜随访、术腔护理及糖皮质激素雷诺考特鼻内应用,对绝大多数患者有效。普米克令舒鼻内雾化结合其他治疗能治愈少数迁延性鼻-鼻窦炎。Objective：To investigate the effect of inhalation of atomized pulmicort on persistent rhino-sinusitis after endoscopic sinus surgery （ESS） for chronic sinusitis. Methods： Sixteen patients with persistent rhino-sinusitis were enrolled from 362 post-operative patients with chronic sinusitis from Aug. 2003 to Dec. 2005, in whom the postsurgical care for the cavity, sinus washing, and intranasal local glucocorticoid rhinocort were recorded. The sixteen patients received intranasal inhalation of atomized pulmicort for 16 days combined with the postsurgical care for the cavity and oral antibiotics. Then the clinical effect was evaluated in the follow-up survey. The evaluation was made according to the ESS standard of Haikou in 1997. Results： The pre-operative diagnosis of sixteen patients with persistent rhinosinusitis was type Ⅱ or Ⅲ chronic sinusitis with allergic rhinitis. The postsurgical care for nasal cavity with endoscopy was managed for over 3 months. After intranasal inhalation of atomized pulmicort combined with the postsurgical care for the cavity and oral antibiotics, an improvement in the symptoms of sinusitis and allergic rhinitis was found in 16 patients during 3 months of the followed-up, and the courses of dry and the epithelial metaplasia in the nasal cavity and sinus was markedly reduced. Conclusion： Intranasal inhalation of atomized pulmicort, combined with the postsurgical care for the cavity and oral antibiotics, can control persistent rhino-sinusitis after surgery.

关 键 词：慢性鼻窦炎 内镜术 吸入布地奈德混悬液 

分 类 号：R765.41[医药卫生—耳鼻咽喉科] R977.11[医药卫生—临床医学]