慢性鼻-鼻窦炎内镜手术应用布地奈德混悬液中鼻道浸润的长期疗效观察  

Long-term outcome of budesonide middle meatus treatment for chronic rhinosinusitis patients following endoscopic sinus surgery

作　　者：陈晓栋[1] 王海婷[1] 石照辉[1] 李晓媛[1] 单伯仪[1] 薛涛[1] 乔莉[1] 陈福权[1] 

机构地区：[1]第四军医大学西京医院耳鼻咽喉头颈外科,西安710032

出　　处：《临床耳鼻咽喉头颈外科杂志》2016年第3期203-205,208,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:探讨慢性鼻-鼻窦炎内镜手术应用布地奈德混悬液中鼻道浸润的长期疗效。方法:将53例慢性鼻-鼻窦炎患者分为布地奈德组和对照组,其中布地奈德组21例(39.6%),对照组32例(60.4%)。布地奈德组于鼻内镜鼻窦手术完成时每侧中鼻道放置1ml吸入用布地奈德混悬液浸润的明胶海绵,对照组中鼻道只放置明胶海绵。术前及术后24个月分别对患者进行视觉模拟量表(VAS)、鼻窦炎生活质量量表(SNOT-20)及LundKennedy内镜评分。结果:布地奈德组VAS及SNOT-20评分术前与术后比较,差异均有统计学意义(P<0.05);Lund-Kennedy内镜评分术前与术后比较,差异均有统计学意义(P<0.05)。对照组VAS及SNOT-20评分术前与术后比较,差异均有统计学意义(P<0.05);Lund-Kennedy内镜评分术前与术后比较,差异均有统计学意义(P<0.05)。2组总体症状VAS评分术前与术后比较,差异均有统计学意义(P<0.05);但2组术前与术后SNOT-20评分与2组术前与术后Lund-Kennedy内镜评分比较,差异均无统计学意义(P>0.05)。结论:慢性鼻-鼻窦炎经鼻内镜鼻窦手术应用布地奈德混悬液中鼻道浸润,是一种安全、便捷、有效的方法,可改善患者手术后鼻部症状。Objective：To investigate the long term clinical effect of budesonide treatment in middle meatus for chronic rhinosinusitis（CRS）following endoscopic sinus surgery（ESS）.Method：A total number of 53 patients with CRS received ESS were divided into two groups according to budesonide treatment：budesonide-treated group with 21 cases（39.6%）and control group with 32 cases（60.4%）.Gelatin sponges soaked with 1ml budesonide suspension were put in middle meatus in budesonide-treated group,while only gelatin sponges were put in middle meatus in control group.Visual analogy score（VAS）,sino-nasal outcome test-22（SNOT-22）and Lund-Kennedy endoscopic scale were carried out before ESS and two years after ESS.Result：In budesonide-treated group,there were a statistical difference before and after ESS in the VAS,SNOT-20 and Lund-Kennedy score（P〈0.05）.In control group,difference was also significant in VAS,SNOT-20 and Lund-Kennedy score before and after ESS（P〈0.05）.The VAS gap of post-operative and pre-operative in two groups are significantly different（P〈0.05）.However,there was no significant difference in the SNOT-20 and Lund-Kennedy endoscopic scale gap before or after the operation between two groups.Conclusion：It is safe,convenient and practicable to perform budesonide treatment in middle meatus following ESS,which can significantly ease the post-operative discomfort of nose.

关 键 词：鼻窦炎 内镜鼻窦手术 糖皮质激素类 布地奈德 

分 类 号：R765.4[医药卫生—耳鼻咽喉科]