嗜酸性粒细胞型鼻息肉内镜术中植入全降解鼻窦药物支架的疗效观察  

Efficacy of endoscopic sinus surgery with absorbable sinus drug stents in eosinophilic nasal polyps

作　　者：王奎吉[1] 娄鸿飞[1] 王成硕[1,2] 张罗[1,2] WANG Kuiji;LOU Hongfei;WANG Chengshuo;ZHANG Luo(Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Beijing,100730,China;Beijing Institute of Otolaryngology,Beijing Key Laboratory of Nasal Diseases,Beijing,100005,China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100730 [2]北京市耳鼻咽喉科研究所,鼻病研究北京市重点实验室,北京100005

出　　处：《中国耳鼻咽喉头颈外科》2021年第4期199-202,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：北京市医院管理局使命计划(SML20150203);北京市医院管理局登峰人才培养计划(DFL20190202);北京市医院管理局临床技术创新项目(XMLX201816);首都卫生发展基金(2016-1-2052);“青年北京学者”计划(2019年);首都健康保障培育研究项目(Z181100001618002);教育部长江学者与创新团队发展计划(IRT13082);国家杰出青年科学基金项目计划(82025010);国家自然科学基金重点项目(81630023);国家自然科学基金重点国际合作研究项目(81420108009);国家自然科学基金面上项目(81870698、81970850);国家重点研发计划数字诊疗装备研发重点专项(2018YFC0116801)。

摘　　要：目的探讨嗜酸性粒细胞型鼻息肉内镜术中应用全降解鼻窦药物支架对临床疗效的影响。方法入组行鼻内镜手术的嗜酸性粒细胞型鼻息肉患者15例,设计自身对照研究,将双侧鼻腔随机分为支架侧与对照侧。支架侧内镜术中植入全降解鼻窦药物支架;对照侧鼻腔未植入全降解鼻窦药物支架。分别于内镜术前,术后2周、1个月、2个月、3个月进行随访评估,主要评估指标为鼻部症状视觉模拟量表评分、Lund-Kennedy鼻内镜评分、黏膜病理嗜酸性粒细胞计数。结果支架侧鼻内镜评分在术后3个月时明显低于对照侧(1.786±1.051 vs 2.643±1.151,t=2.064,P=0.0208);黏膜病理嗜酸性粒细胞计数在术后1个月时显著低于对照侧(61.33±28.50 vs 84.33±27.83,t=3.044,P=0.0088);鼻部症状视觉模拟量表评分双侧无明显差异。结论嗜酸性粒细胞型鼻息肉内镜术中应用全降解鼻窦药物支架可以抑制黏膜炎症,改善鼻内镜评分,促进术腔良性转归。OBJECTIVE To investigate the efficacy of endoscopic sinus surgery with absorbable sinus drug stents in the treatment of eosinophilic nasal polyps.METHODSFifteen patients with eosinophilic nasal polyps who underwent endoscopic sinus surgery were enrolled.A self-controlled study was designed,and the bilateral nasal cavities were randomized into either the drug stent side or the control side.Absorbable sinus drug stents were implanted in the drug stent side during endoscopic surgery,and the control side did not receive the implant with absorbable sinus drug stent.The efficacy were evaluated at baseline,the second week and the first,second,and third months after surgery.The main evaluation indicators were the visual analogue score of nasal symptoms,the Lund-Kennedy nasal endoscopy score and eosinophilic cell count in mucosa.RESULTS Lund-Kennedy score of the stent-side was significantly lower than the control side at 3 months after surgery(1.786±1.051 vs 2.643±1.151,t=2.064,P=0.0208),and eosinophil count in mucosa was significantly lower than the control side at 1 month after surgery(61.33±28.50 vs 84.33±27.83,t=3.044,P=0.0088).Visual analogue score of nasal symptoms showed no significant difference between two sides.CONCLUSION The application of absorbable sinus drug stent in endoscopic surgery is beneficial to inhibit eosinophil inflammation and reduce postoperative endoscopic score in eosinophilic chronic rhinosinusitis with nasal polyps.

关 键 词：鼻息肉 嗜酸细胞 内窥镜检查 嗜酸性粒细胞型鼻息肉 全降解鼻窦药物支架 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]