慢性鼻窦炎伴鼻息肉患者双侧额窦植入缓释糖皮质激素支架的回顾性研究  

Retrospective study of bilateral frontal sinus stent implantation in patients with chronic rhinosinusitis with nasal polyps undergoing full functional endoscopic sinus surgery

作　　者：施晓琼 高颖娜 段祥强 朱敏辉 宋静 周励 郑宏良 唐海红 SHI Xiaoqiong;GAO Yingna;DUAN Xiangqiang;ZHU Minhui;SONG Jing;ZHOU Li;ZHENG Hongliang;TANG Haihong(Department of Otolaryngology,Changhai Hospital,Naval Medical University,Shanghai,200433,China)

机构地区：[1]海军军医大学第一附属医院(上海长海医院)耳鼻咽喉科,上海200433

出　　处：《中国耳鼻咽喉头颈外科》2024年第2期105-108,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的评估缓释糖皮质激素支架(简称支架)在全组慢性鼻窦炎伴息肉(CRSwNP)患者双侧额窦口植入对全组鼻窦内镜开放手术后主观症状的影响以及额窦、筛窦术区创面恢复的疗效。方法回顾性分析2018年1月~2021年10月长海医院耳鼻咽喉头颈外科收治的130例全组CRSwNP患者的病例资料,单纯行全组鼻窦内镜开放手术的92例患者为对照组,全组鼻窦内镜开放手术后双侧额窦口植入支架的38例患者为支架组。比较两组患者术后第30天、第90天主观症状视觉模拟量表评分以及额窦、额窦术区愈合情况的差异。结果术后第30天、第90天,支架组总体症状改善程度明显优于对照组(P<0.05)。术后第30天内镜检查评估显示,支架组额窦术区需要术后干预的比例相比对照组降低42.3%(P<0.05),筛窦术区需要术后干预的患者比例较对照组降低17.7%(P>0.05)。术后第90天的内镜检查评估结果与第30天的情况一致。结论支架在双侧额窦术区的植入有利于术后主观症状的改善,并能有效降低术后再干预的可能。OBJECTIVE To assess the efficacy of bioabsorbable steroid-releasing sinus stents for improving surgical outcomes and subjective symptoms when placed in the bilateral frontal sinus opening(FSO)following full functional endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).METHODS CRSwNP patients who had under full functional endoscopic sinus surgery with complete data of nasal endoscopy and sinus computed tomography data were identified and included in the study.The patients were divided into a control group consisting of patients receiving only full functional endoscopic sinus surgery(n=92)and a stent group consisting of patients receiving full functional endoscopic sinus surgery combined with placement of steroid implants in both FSO(n=38).The visual analogue scale(VAS)subjective symptom scores and surgical outcomes were compared preoperatively,and on postoperative day(PD30 and PD90)between the two groups.RESULTS Compared to baseline,the overall symptom VAS scores of patients after operation decreased significantly in both groups(P<0.05),and the degree of improvement of overall symptoms in the stent group was significantly better than in the control group(P<0.05).On PD30,the proportion of patients requiring postoperative interventions for bilateral FSO was reduced by 42.3%in the stent group,and was significantly lower than in the control group(P<0.05).Compared to the control group,the proportion of patients needing postoperative intervention in both ethmoid sinus on the stent group decreased by 17.7%(P>0.05).The results at PD90 were consistent with those at PD30.CONCLUSION Full functional endoscopic sinus surgery in combination with bilateral frontal sinus stent implantation is better than full functional endoscopic sinus surgery alone.

关 键 词：药物洗脱支架 糖皮质激素类 内窥镜检查 鼻窦炎 鼻息肉 缓释糖皮质激素支架 全组鼻窦内镜开放术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]