改良鼻丘径路额窦鼻内镜修正术结合布地奈德治疗鼻窦炎伴鼻息肉的疗效观察  

Observation on the effect of modified endoscopic frontal sinus surgery via agger nasi approach combined with budesonide in the treatment of chronic sinusitis complicated by nasal polyps

作　　者：张连生 Zhang Liansheng(Department of Otolaryngology,Zhumadian Central Hospital,Zhumadian 463000,China)

机构地区：[1]驻马店市中心医院耳鼻咽喉科,驻马店463000

出　　处：《中国实用医刊》2024年第7期41-44,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨改良鼻丘径路额窦鼻内镜修正术结合布地奈德治疗慢性鼻窦炎伴鼻息肉的临床疗效。方法队列研究。抽取2022年1月至2023年6月在驻马店市中心医院就诊的慢性鼻窦炎伴鼻息肉患者120例,按随机数字表法分为单一组和联合组,每组60例。单一组仅采用改良鼻丘径路额窦鼻内镜修正术治疗,联合组采用改良鼻丘径路额窦鼻内镜修正术结合布地奈德治疗。比较两组患者的临床疗效、嗅觉功能评分[嗅觉识别阈值测试评分法(TDI)]、鼻黏膜纤毛清除率、鼻黏膜纤毛清除速度、鼻窦CT Lund-Mackay评分、术后并发症发生情况和复发情况。结果联合组疗效的优良率(93.33%,56/60)高于单一组(76.67%,46/60),差异有统计学意义(P<0.05)。术后,两组TDI评分、鼻黏膜纤毛清除率、鼻黏膜纤毛清除速度均高于术前,且联合组上述指标高于单一组,差异有统计学意义(P<0.05);两组鼻窦CT Lund-Mackay评分均低于术前,且联合组低于单一组(P<0.05)。两组患者术后并发症发生率比较差异未见统计学意义(P>0.05)。联合组术后6个月内的复发率(6.67%,4/60)低于单一组(16.67%,10/60),差异有统计学意义(P<0.05)。结论改良鼻丘径路额窦鼻内镜修正术结合布地奈德治疗慢性鼻窦炎伴鼻息肉患者能够提高临床疗效,改善嗅觉功能、鼻黏膜纤毛清除功能,减轻鼻窦炎症,减少复发风险,值得临床推广应用。Objective To investigate the clinical efficacy of modified endoscopic frontal sinus surgery via agger nasi approach combined with budesonide in the treatment of chronic sinusitis complicated by nasal polyps.Methods A cohort study was adopted in this study.A total of 120 patients with chronic sinusitis complicated by nasal polyps treated in Zhumadian Central Hospital from January 2022 to June 2023 were selected,and they were divided into the single group and the combination group by random number table method,with 60 cases in each group.The single group was treated by modified endoscopic frontal sinus surgery via agger nasi approach alone,while the combination group was treated by modified endoscopic frontal sinus surgery via agger nasi approach combined with budesonide.The clinical efficacy,olfactory function score evaluated by threshold,discrimination and identification test(TDI),nasal mucociliary clearance rate,nasal mucociliary clearance speed,sinus computed tomography(CT)Lund-Mackay score,postoperative complications and recurrence were compared between the two groups.Results The excellent rate of curative effect of the combination group(93.33%,56/60)was higher than that of the single group(76.67%,46/60),and the difference was statistically significant(P<0.05).After surgery,the TDI score,nasal mucociliary clearance rate,and nasal mucociliary clearance speed of the two groups were higher than those before surgery,and the above indicators of the combination group were higher than those of the single group(P<0.05).After surgery,the sinus CT Lund-Mackay score of the two groups were lower than those before surgery,and the sinus CT Lund-Mackay score of the combination group was lower than that of the single group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05);but the recurrence rate of the combination group(6.67%,4/60)was lower than that of the single group(16.67%,10/60),P<0.05.Conclusions Modified endoscopic frontal sinus surgery via agger

关 键 词：鼻窦炎 慢性鼻窦炎伴鼻息肉 改良鼻丘径路额窦鼻内镜修正术 布地奈德 嗅觉功能 鼻黏膜纤毛清除功能 鼻窦CT评分 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]