鼻窦药物支架在复发性鼻窦炎中的短期疗效  

Short-term efficacy of sinus drug stents in patients with recurrent rhinosinusitis

作　　者：李德宏[1] 倪茂美[1] 任娟娟[1] 曹长兴[1] 王敏[1] LI Dehong;NI Maomei;REN Juanjuan;CAO Changxing;WANG Min(Department of Otolaryngology,Guizhou Provincial People′s Hospital,Guiyang 550002,China)

机构地区：[1]贵州省人民医院耳鼻咽喉头颈外科,贵阳550002

出　　处：《实用医学杂志》2023年第3期315-320,共6页The Journal of Practical Medicine

基　　金：贵州省卫健委资助项目(编号:gzwkj2022-160)。

摘　　要：目的 评估复发性鼻窦炎(RRS)患者行修正性内镜鼻窦手术(ESS)术中植入全降解鼻窦药物支架(SES)对术区创面恢复的短期疗效。方法 选择由同一术者完成手术的复发性鼻窦炎患者,自身对照方法在ESS术中随机分为支架侧(支架组)和对照侧(对照组)。术后30、90 d,由独立评估小组根据内镜检查结果评估支架侧和对照侧术区恢复情况,进行内镜评分和确定是否需要进行术后干预(手术和口服激素干预)。结果 共计纳入的30例复发性鼻窦炎患者,术后30 d,支架组相比对照组术后需要干预的比例降低了50%(χ^(2)=5.514,P=0.007 0),其中手术干预下降50%(χ^(2)=4.921,P=0.043 9),口服激素干预下降了50%(χ^(2)=5.292,P=0.022 7),额窦口通畅度提高60%(χ^(2)=5.343,P=0.034);术后90 d,支架组相比对照组术后需要干预的比例下降50%(χ^(2)=5.414,P=0.024 5),其中手术干预下降42.8%(χ^(2)=4.887,P=0.033 9),口服激素干预下降了66.7%(χ^(2)=5.492,P=0.042 7),额窦口通畅度提高44.4%(χ^(2)=4.343,P=0.044),炎症评分(VAS)差异有统计学意义(χ^(2)=5.242,P=0.035)。结论 RRS术中置入SES提高了额窦术后的通畅性,降低了ESS术后再干预的可能和术后的炎性反应,SES治疗复发性鼻窦炎的短期效果有效。Objective Evaluation of the short term efficacy of fully degraded sinus drug-stents(SES)implanted during modified endoscopic sinus surgery(ESS)in patients with Recurrent Rhinosinusitis(RRS).Methods Patients with recurrent sinusitis who were operated by the same surgeon were selected and randomly divided into stent side and control side after ESS by self-control method.At 30 and 90 days after surgery,an independent evaluation team evaluated the recovery of the stent and control sites based on the endoscopic findings,performed endoscopic scores(VAS),and determined the need for postoperative intervention(surgery and oral hormone intervention).Results A total of 30 patients with recurrent sinusitis were included in this study.At 30 days after surgery,the proportion of patients requiring postoperative intervention in the stent group decreased by 50%compared with the control group(χ^(2)=5.514,P=0.0070),including 50%for surgical intervention(χ^(2)=4.921,P=0.0439)and 50%for oral hormone intervention(χ^(2)=5.292,P=0.0227).The patency of frontal sinus was increased by 60%(χ^(2)=5.343,P=0.034).At 90 days post-ESS,the proportion of postoperative intervention in the stent group decreased by 50%compared with the control group(χ^(2)=5.414,P=0.0245),among which,surgical intervention decreased by 42.8%(χ^(2)=4.887,P=0.0339),and oral hormone intervention decreased by66.7%(χ^(2)=5.492,P=0.0427).The patency of frontal sinus opening was increased by 44.4%(χ^(2)=4.343,P=0.044),and the inflammation score(VAS)was significantly different(χ^(2)=5.242,P=0.035).Conclusion The implantation of SES in RRS improves the postoperative patency of frontal sinus,reduces the possibility of reintervention after ESS and postoperative inflammatory response,and the short-term effect of SES in the treatment of recurrent sinusitis is effective.

关 键 词：复发性鼻窦炎 内镜手术 全降解鼻窦药物支架 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]