个体化精准鼻窦激素给药器治疗复发性慢性鼻窦炎伴鼻息肉  

Clinical study on the treatment of recurrent chronic rhinosinusitis with nasal polyps with individualized precise nasal sinus hormone dispenser

作　　者：李安 赵玉祥[1] 赵克中 杨双元 赵美美 朱旭利 高旭栋 王骏[1] LI An;ZHAO Yuxiang;ZHAO Kezhong;YANG Shuangyuan;ZHAO Meimei;ZHU Xuli;GAO Xudong;WANG Jun(Department of Otolaryngology Head and Neck Surgery,People's Hospital of Shanxi Province,Xi'an 710068,China;Xi'an Technological University,Xi'an 710021,China;Xi'an Medical University,Xi'an 710068,China)

机构地区：[1]陕西省人民医院耳鼻咽喉头颈外科,西安710068 [2]西安工业大学,西安710021 [3]西安医学院,西安710068

出　　处：《长春中医药大学学报》2023年第8期921-924,共4页Journal of Changchun University of Chinese Medicine

基　　金：陕西省重点研发计划项目(2020SF-198)。

摘　　要：目的探讨鼻内镜手术联合个体化精准鼻窦激素给药器治疗复发性慢性鼻窦炎伴鼻息肉(CRSwNP)的临床效果。方法选择60例复发性CRSwNP患者,随机分为对照组与观察组,各30例。2组均予根治性鼻内镜鼻窦手术,术后对照组采用常规鼻喷激素治疗,观察组采用个体化精准鼻窦激素给药器治疗。观察至术后12个月,比较2组临床疗效、内镜Lund-Kennedy评分、嗅觉功能、鼻黏膜功能、鼻腔鼻窦结局测试22量表(SNOT-22)评分及复发率。结果术后12个月,观察组总有效率高于对照组,复发率低于对照组(P<0.05);观察组内镜Lund-Kennedy评分、SNOT22评分低于对照组(P<0.05);观察组气味辨别能力、气味识别能力、气味感觉阈值及总分高于对照组(P<0.05);观察组纤毛清除率、纤毛清除速度高于对照组(P<0.05)。结论鼻内镜手术联合个体化精准鼻窦激素给药器能显著提高复发性CRSwNP的临床治疗效果,减轻术后炎症反应,促进嗅觉功能及鼻黏膜功能恢复,提高生活质量,降低复发风险。Objective To investigate the clinical effect of endoscopic sinus surgery combined with the individualized precise nasal sinus hormone dispenser in the treatment of recurrent chronic rhinosinusitis with nasal polyps(CRSwNP).Methods A total of 60 patients with recurrent CRSwNP were selected and randomly divided into the control group and the observation group,with 30 cases in each group.Both groups were treated with radical endoscopic sinus surgery.The control group was treated with the routine nasal spray hormone,and the observation group was treated with the individualized precise nasal sinus hormone dispenser after the operation.The clinical efficacy,endoscopic Lund-Kennedy scores,olfactory function,nasal mucosal function,22-items Sinonasal Outcome Test(SNOT-22)scores and recurrence rate were compared between the two groups at 12 months after operation.Results At 12 months after operation,in the observation group the total effective rate was higher than that in the control group,and the recurrence rate was lower than that in the control group(P<0.05).The endoscopic Lund-Kennedy scores and SNOT-22 scores in the observation group were lower than those in the control group(P<0.05).The odor discrimination ability,odor recognition ability,odor perception threshold and total score of the observation group were higher than those of the control group(P<0.05).The cilia clearance rate and cilia clearance speed in the observation group were higher than those in the control group(P<0.05).Conclusion Endoscopic sinus surgery combined with the individualized precise nasal sinus hormone dispenser can significantly improve the clinical treatment effect of recurrent CRSwNP,reduce postoperative inflammatory reactions,promote the recovery of the olfactory function and the nasal mucosal function,improve the quality of life of the patients and reduce the risk of recurrence of the disease.

关 键 词：慢性鼻窦炎 鼻息肉 鼻内镜手术 精准给药 嗅觉功能 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]