功能性鼻内镜鼻腔鼻窦术后植入糖皮质激素鼻窦支架对慢性鼻窦炎鼻息肉术腔良性转归的影响  

Influence of glucocorticoid sinus stent implantation after FESS on benign outcomes of surgical cavity in patients with CRSwNP

作　　者：侯薇 袁浩展 王艳婷 HOU Wei;YUAN Hao-zhan;WANG Yan-ting(Department of Otorhinolaryngology,Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi,China)

机构地区：[1]陕西中医药大学附属医院耳鼻喉科,陕西咸阳712000

出　　处：《川北医学院学报》2024年第8期1026-1029,共4页Journal of North Sichuan Medical College

基　　金：陕西省国际合作重点项目(No.2020kwz-019)。

摘　　要：目的:探究功能性鼻内镜鼻腔鼻窦(FESS)术后植入糖皮质激素鼻窦支架对慢性鼻窦炎鼻息肉(CRSwNP)术腔良性转归的影响。方法:选取110例CRSwNP拟行FESS术治疗的患者作为研究对象,根据手术方式不同将其分为对照组与支架组,每组各55例。对照组患者FESS术后予以常规术腔清理;支架组患者FESS术后两周行术腔清理并植入糖皮质激素鼻窦支架。比较两组患者症状改善情况、疼痛情况(VAS)、内镜评分(LKS)、鼻窦结局测试评分(SNOT)、鼻黏膜嗜酸性粒细胞、杯状细胞计数水平、不良反应发生情况和复发率。结果:支架组患者术后改善情况优于对照组(P<0.05);术后4、8、12周,两组患者VAS、LKS、SNOT评分均逐渐下降(P<0.05),且支架组各时间点均低于对照组(P<0.05);术后6个月,两组鼻黏膜嗜酸性粒细胞计数均下降(P<0.05),且支架组低于对照组(P<0.05),杯状细胞计数上升(P<0.05),且支架组高于对照组(P<0.05);两组患者不良反应总发生率无统计学差异(P>0.05);支架组复发3例(5.45%),对照组复发10例(18.18%),差异有统计学意义(χ^(2)=4.274,P=0.039)。结论:FESS术后植入糖皮质激素鼻窦支架可显著改善CRSwNP患者临床症状及降低复发率,对术腔良性转归具有积极意义。Objective:To investigate the influence of glucocorticoid sinus stent implantation after functional endoscopic sinus surgery(FESS)on the benign outcomes of surgical cavity in patients with chronic rhinosinusitis with nasal polyp(CRSwNP).Methods:A retrospective analysis was performed on patients with CRSwNP who were scheduled to undergo FESS.According to different surgical methods,they were divided into control group(n=55,routine surgical cavity cleaning after FESS surgery)and stent group(n=55,2 weeks after FESS surgery,perform surgical cavity cleaning and implant glucocorticoid sinus stent).The improvement of symptoms,pain level(VAS),endoscopic score(LKS),sinus outcome test score(SNOT),nasal mucosal eosinophil and goblet cell count levels,adverse reactions,and recurrence rate were compared between the two groups.Results:The postoperative improvement of patients in the stent group was better than that in the control group(P<0.05).The postoperative VAS,LKS,and SNOT scores of both groups of patients showed a significant downward trend 4,8,and 12 weeks postoperatively(P<0.05),and the postoperative scores of the stent group were lower than those of the control group(P<0.05).After 6 months of surgery,the eosinophil count of the nasal mucosa in both groups decreased(P<0.05),and the stent group was lower than the control group(P<0.05).The goblet cell count increased(P<0.05),and the scaffold group was lower than the control group(P<0.05).There was no statistically significant difference in adverse reactions between the two groups of drugs(P>0.05).There were 3 relapses in the stent group(5.45%)and 10 relapses in the control group(18.18%),with statistically significant differences(χ^(2)=4.274,P=0.039).Conclusion:Glucocorticoid sinus stent implantation after FESS can significantly improve the clinical symptoms and reduce the recurrence rate in CRSwNP patients.It has positive significance for the benign outcomes of surgical cavity.

关 键 词：慢性鼻窦炎鼻息肉 功能性鼻内镜鼻腔鼻窦术 糖皮质激素鼻窦支架 嗜酸性粒细胞 

分 类 号：R765.41[医药卫生—耳鼻咽喉科] R765.9[医药卫生—临床医学]