地塞米松联合医用胶原蛋白海绵在鼻内镜手术后复查中的应用  

Application of dexamethasone combined with medical collagen sponge in nasal endoscopic operation follow- up

作　　者：谢天宏[1] 黄兴玉[1] 贺元杰[1] 

机构地区：[1]遵义医学院附属医院耳鼻喉科,贵州遵义563099

出　　处：《遵义医学院学报》2014年第1期103-105,共3页Journal of Zunyi Medical University

摘　　要：目的探讨地塞米松联合医用胶原蛋白海绵对鼻内镜手术后术腔上皮化的影响。方法将符合入选标准的功能性鼻内镜鼻窦手术术后患者92例,随机分为激素及医用胶原蛋白干扰组(50例)和单纯明胶海绵处理对照组(42例),术腔均进行分离粘连、吸破囊泡、鼻动力系统切除息肉等处理,干扰组术腔行地塞米松联合医用胶原蛋白海绵填塞,对照组术腔行明胶海绵填塞。根据术区恢复情况制定个性化定期复查,随诊6月。结果干扰组:完全上皮化43例(86%),部分上皮化5例(10%),无效2例(4%)。对照组:完全上皮化30例(71.4%),部分上皮化7例(16.7%),无效5例(11.9%),干扰组完全上皮化高于对照组,差异有统计学意义(P<0.05)。两组部分上皮化比较无统计学意义(P﹥0.05)。每次复查平均用时:干扰组(6.1±2.2)min,对照组(16.4±2.5)min,差异有统计学意义(P<0.05)。完全上皮化病例复查次数:干扰组(4.3±0.2)次,对照组(7.8±0.8)次,差异有统计学意义(P<0.05)。结论地塞米松联合医用胶原蛋白海绵应用于功能性鼻内镜鼻窦手术术后术腔,可减少鼻腔粘连、出血、囊泡及息肉复发,减轻黏膜炎性反应和水肿,促进术腔上皮化,明显缩短治愈慢性鼻窦炎的疗程,值得临床上推广运用。Objective To investigate the effect of dexamethasone combined with medical collagen sponge on the cavity epithelization after endoscopic operation. Methods The 92 patients with functional endoscopic sinus opera- tion meeting the inclusion criteria, were randomly divided into hormone and medical collagen interference group （50 cases） and pure gelatin sponge treatment control group （42 cases）. Nasal cavity were performed separating adhesion, suction broken vesicles, and nasal polypectomy with dynamic system processing. In interference group the cavity was treated with dexamethasone combined with medical collagen sponge, the cavity of control group was treated with gelatin sponge packing. According to the operation area recovery to develop personalized follow - up for 6 months. Results The interference groups： complete epithelization in 43 cases （86%）, partial epithel- ization 5 cases （10%）, ineffective 2 cases （4%）. Control group： complete epithelization 30 cases （71.4%）, partial epithelization 7 cases （ 16.7% ）, and ineffective 5 cases （ 11.9% ）. The percentage of complete epi- thelization in interference group was higher than the control group （ P 〈 0.05 ）. The epithelial change between two groups showed no statistical significance （ P 〉 0.05 ）. The average examination time ： interference group （6.1 ± 2.2 ） rain, the control group （ 16.4 ± 2.5 ） min, the difference was statistically significant （ P 〈 0. 05）. Complete epithelization case follow- up times： interference group （4.3 ±0.2） was shorter than control group （7.8 ± 0.8 ） （ P 〈 0.05 ）. Conclusion Dexamethasone combined with medical collagen sponge appli-cation after endoscopic sinus surgery can reduce the adhesion of nasal cavity, hemorrhage, vesicles and polyp recurrence. It can also reduce mucosal inflammation and edema, promote re - epithelization operation, shorten the treatment of chronic sinusitis, and is worthy of clinical application.

关 键 词：功能性鼻内镜鼻窦手术 地塞米松 医用胶原蛋白海绵 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]