术前布地奈德预处理在鼻内镜手术治疗CRSwNP患者中的应用效果  

Application Effect of Preoperative Budesonide Pretreatment in the Treatment of Patients with CRSwNP under Nasal Endoscopic Surgery

作　　者：危高生 李晓军 WEI Gaosheng;LI Xiaojun(Yingtan City People's Hospital,Jiangxi Province,Yingtan 335000,China;不详)

机构地区：[1]江西省鹰潭市人民医院,江西鹰潭335000

出　　处：《中国医学创新》2023年第5期58-62,共5页Medical Innovation of China

基　　金：江西省鹰潭市科技计划项目(课题)(YKZ20180043)。

摘　　要：目的:探讨手术前给予布地奈德预处理在鼻内镜手术治疗慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)患者的中的应用效果及对鼻黏膜纤毛清除功能、血清总免疫球蛋白E(TIgE)、嗜酸粒细胞阳离子蛋白(ECP)的影响。方法:选取2018年1月-2020年1月鹰潭市人民医院拟接受鼻内镜手术治疗的CRSwNP患者60例作为临床研究对象,采用随机数字表法分为研究组和对照组,各30例。研究组术前1周给予布地奈德进行干预,对照组仅给予安慰剂。对比两组患者手术治疗的效果、手术前后各项临床症状评分、鼻黏膜纤毛清除功能及组织中Bach2蛋白的表达差异。结果:手术前,两组患者的SNOT-20评分、Lund-Kennedy评分对比,差异均无统计学意义(P>0.05);手术后3个月,两组患者的SNOT-20评分、Lund-Kennedy评分均低于治疗前,研究组均低于对照组,差异均有统计学意义(P<0.05)。手术前,两组患者的鼻黏液纤毛清除率、鼻黏液纤毛清除速度、糖精消除时间对比,差异均无统计学意义(P>0.05);手术后3个月,研究组的鼻黏液纤毛清除率大于对照组,差异有统计学意义(P<0.05)。手术前,两组患者的血清TIgE、ECP水平对比,差异均无统计学意义(P>0.05);手术后3个月,研究组的血清ECP水平低于对照组,差异有统计学意义(P<0.05)。研究组总体临床疗效优于对照组,差异有统计学意义(P<0.05)。结论:手术前给予布地奈德预处理有助于缓解鼻内镜术后CRSwNP患者临床症状,改善免疫功能,提高治疗效果。Objective:To explore the application effect of Budesonide pretreatment before operation in the treatment of patients with chronic rhinosinusitis with nasal polyps(CRSwNP)under nasal endoscopic surgery and its effect on nasal mucosal ciliary clearance,serum total immunoglobulin E(TIgE),eosinophil cationic protein(ECP).Method:A total of 60 patients with CRSwNP who were planned to undergo nasal endoscopic surgery in Yingtan City People’s Hospital from January 2018 to January 2020 were selected as clinical study subjects,they were divided into study group and control group by random number table method,with 30 patients in each group.The study group was given Budesonide for intervention one week before surgery,while the control group was only given placebo.The effects of surgical treatment,the scores of clinical symptoms before and after surgery,the ciliary clearance function of nasal mucosa and the expression of Bach2 protein in tissues were compared between the two groups.Result:Before surgery,there were no significant differences in SNOT-20 scores and Lund-Kennedy scores between the two groups(P>0.05);three months after the surgery,the SNOT-20 scores and Lund-Kennedy scores of the two groups were lower than those before treatment,and the study group were lower than those of the control group,the differences were statistically significant(P<0.05).Before surgery,there were no statistically significant differences in nasal mucociliary clearance rate,nasal mucociliary clearance rate and saccharin clearance time between the two groups(P>0.05);three months after surgery,the nasal mucociliary clearance rate in the study group was higher than that in the control group,with a statistically significant difference(P<0.05).Before surgery,there were no significant differences in the levels of serum TIgE and ECP between the two groups(P>0.05);three months after surgery,the serum ECP level in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).The overall clinical effica

关 键 词：布地奈德 慢性鼻-鼻窦炎伴鼻息肉 鼻内镜手术 血清总免疫球蛋白E 嗜酸粒细胞阳离子蛋白 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]