功能性鼻内窥镜手术联合地塞米松鼻腔冲洗对鼻窦炎患者的临床研究  

Clinical study of functional endoscopic sinus surgery combined with dexamethasone nasal irrigation in patients with sinusitis

作　　者：罗雪仪 蒋迪 陈顺金[1] 傅明 LUO Xueyi;JIANG Di;CHEN Shunjin;FU Ming(Department of Otolaryngology,The Tenth Affiliated Hospital,Southern Medical University/Dongguan People's Hospital,Dongguan 523000)

机构地区：[1]南方医科大学第十附属医院/东莞市人民医院耳鼻咽喉科,东莞523000

出　　处：《湖南师范大学学报(医学版)》2024年第5期70-74,共5页Journal of Hunan Normal University(Medical Sciences)

基　　金：东莞市社会发展科技项目“慢性鼻一鼻窦炎伴鼻息肉患者细胞间黏附分子-1与Ⅱ型固有淋巴细胞的表达及临床意义研究”(20211800903732);广东省基础与应用基础研究基金区域联合基金项目(地区培育项目)“CSF1/CCL22反馈环介导鼻咽癌细胞与TAMs相互作用促鼻咽癌转移的分子机制”(2021B1515140070)

摘　　要：目的:分析功能性鼻内窥镜手术(functional endoscopic sinus surgery,FESS)联合地塞米松鼻腔冲洗对慢性鼻窦炎(chronic sinusitis,CRS)患者临床症状、炎症反应及血清过敏原特异性IgE(specific immunoglobulin E,sIgE)、嗜酸性粒细胞(eosinophil,EOS)水平的影响。方法:选取2022年10月—2023年10月在我院治疗CRS患者150例,按照乱数表法分为研究组及对照组,两组各75例,两组患者均行FESS术,对照组在此基础上用生理盐水鼻腔冲洗,研究组加用地塞米松鼻腔冲洗,比较两组临床症状改善、治疗前后炎症反应及对sIgE和EOS水平的影响。结果:经治疗,研究组临床控制率(97.33%)高于对照组(89.33%);两组临床症状VAS评分均有所降低,且研究组临床症状评分均低于对照组;治疗后,两组炎性因子水平IL-5、IL-6、IL-12水平均有所降低,且研究组低于对照组;两组治疗后sIgE、EOS水平均有所降低,且研究组低于对照组;研究组术后并发症发生率(13.33%)低于对照组术后并发症发生率(29.33%),不良反应发生率比较差异无统计学意义。结论:鼻窦炎患者实施FESS术后联合地塞米松冲洗鼻腔可改善患者临床症状,有效缓解炎症反应,降低sIgE、EOS水平,降低术后并发症。Objective To analyze the effects of functional endoscopic sinus surgery(FESS)combined with dexamethasone nasal irrigation on clinical symptoms,inflammatory response,specific immunoglobulin E(sIgE)and eosinophils(EOS)in patients with sinusitis.Methods A total of 150 patients with CRS in the hospital were enrolled as the research objects between October 2022 and October 2023.According to random number table method,they were divided into study group and control group,75 cases in each group.On basis of FESS,control group was given normal saline,while study group was given dexamethasone for nasal irrigation.The improvement of clinical symptoms,inflammatory response before and after treatment,and the effects on sIgE and EOS were compared between the two groups.Results After treatment,clinical control rate of study group was higher than that of control group(97.33%vs 89.33%,P<0.05).After treatment,scores of nasal congestion,head/facial pain,olfactory disturbance and runny nose were decreased in both groups,which were lower in study group than control group(P<0.05).After treatment,levels of IL-5,IL-6 and IL-12 were decreased in both groups,which were lower in study group than control group.After treatment,levels of sIgE and EOS were decreased in both groups,which were lower in study group than control group.The incidence of postoperative complications in study group was lower than that in control group(13.33%%vs 29.33%,but there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Dexamethasone nasal irrigation can improve clinical symptoms,effectively relieve inflammatory response,reduce sIgE,EOS and postoperative complications in patients with sinusitis after FESS.

关 键 词：慢性鼻窦炎 功能性鼻内窥镜手术 地塞米松 炎症反应 特异性免疫球蛋白 嗜酸粒细胞水平 

分 类 号：R765[医药卫生—耳鼻咽喉科]