术前鼻腔冲洗联合术后康复新液术腔冲洗对慢性鼻窦炎伴鼻息肉患者的影响  

Effects of Preoperative Nasal Irrigation Combined with Surgical Cavity Flushing with Kangfu Xinye after Operation on Chronic Rhinosinusitis with Nasal Polyps

作　　者：胡建欢 任金龙[2] HU Jianhuan;REN Jinlong(Fenyang College of Shanxi Medical University,Fenyang 032200,China;Shanxi Provincial Fenyang Hospital/Fenyang Hospital Affiliated to Shanxi Medical University,Fenyang 032200,China)

机构地区：[1]山西医科大学汾阳学院,山西汾阳032200 [2]山西省汾阳医院/山西医科大学附属汾阳医院,山西汾阳032200

出　　处：《西部中医药》2025年第3期126-130,共5页Western Journal of Traditional Chinese Medicine

基　　金：山西省卫生健康委员会科研课题(2019155)。

摘　　要：目的:观察术前鼻腔冲洗联合术后康复新液术腔冲洗治疗慢性鼻窦炎伴鼻息肉(chronic rhinosinusitis with nasal polyps,CRSwNP)患者的临床疗效。方法:选取60例CRSwNP患者,采用中心分层区组随机法,将患者随机分为甲组、乙组、丙组,每组20例。所有患者均接受内镜鼻窦手术(endoscopic sinus surgery,ESS),甲组给予术前生理盐水+地塞米松+盐酸萘甲唑啉滴鼻液鼻腔冲洗、术后生理盐水冲洗;乙组给予术前生理盐水术腔冲洗、术后康复新液术腔冲洗;丙组给予术前生理盐水+地塞米松+盐酸萘甲唑啉滴鼻液鼻腔冲洗联合术后康复新液术腔冲洗,3组术后均干预12周。比较3组术后鼻黏膜功能、鼻窦炎评分系统(CT Lund-Mackay)评分、临床症状改善情况、术腔黏膜上皮化率、术腔黏膜上皮化时间、术中出血量及不良反应。结果:术后8周,3组鼻黏液纤毛清除率、鼻黏液纤毛清除速度相比,丙组>乙组>甲组,差异有统计学意义(P<0.05);甲组、乙组临床症状各项评分相比差异无统计学意义(P>0.05),丙组临床症状评分低于甲组、乙组(P<0.05);术后12周,3组临床症状评分相比,丙组<乙组<甲组,差异有统计学意义(P<0.05);术后4、8周,3组鼻窦CT Lund-Mackay评分相比,丙组<乙组<甲组,差异有统计学意义(P<0.05)。3组术后4、8、12、24周术腔黏膜上皮化率相比,差异无统计学意义(P>0.05);3组术腔黏膜上皮化时间相比,丙组<乙组<甲组,差异有统计学意义(P<0.05);甲组、丙组术中出血量相比,差异无统计学意义(P>0.05),甲、丙组术中出血量少于乙组(P<0.05)。3组术后不良反应比较,差异无统计学意义(P>0.05)。结论:术前鼻腔冲洗联合术后康复新液术腔冲洗应用于CRSwNP患者中,可明显减少术中出血量,促进手术效果提高,患者临床症状减轻明显,且减轻速度快。Objective:To survey curative effects of preoperative nasal irrigation joined with surgical cavity flushing with Kangfu Xinye in the treatment of chronic rhinosinusitis with nasal polyps(CRSwNP).Methods:Sixty patients were chosen and allocated to group A,group B and group C using centre-stratified block randomisation method(n=20 cases in each group).All the patients accepted endoscopic sinus surgery(ESS),nasal irrigation with normal saline+dexamethasone+nemethazoline hydrochloride nasal drops before the operation,and postoperative flushing with physiological saline were given to group A;preoperative saline irrigation of the operative cavity,and postoperative surgical cavity flushing with Kangfu Xinye were administered to group B;while group C accepted preoperative nasal irrigation with normal saline+dexamethasone+nemethazoline hydrochloride nasal drops and surgical cavity flushing with Kangfu Xinye after operation,three groups adopted 12 weeks of the intervention after the surgery.To compare the function of nasal mucous membrane after the function,the scores of CT Lund-Mackay,the improvements of clinical symptoms,the rate of epithelialisation of the operative cavity mucosa,time of epithelialisation of the operative cavity mucosa,intraoperative bleeding and adverse reaction between the three groups.Results:The difference had statistical meaning in nasal mucus cilia clearance rate,nasal mucus cilia clearance speed between three groups eight weeks after the surgery,group C>group B>group A(P<0.05).No significant difference could be found in the scores of clinical symptoms between group B and group A eight weeks after the surgery(P>0.05);the scores of clinical symptoms in group C were lower than these of group B and group A(P<0.05);the difference was statistically significant in the scores of clinical symptoms between the three groups 12 weeks after the surgery,group C<group B<group A(P<0.05).The difference was statistically significant in the scores of CT Lund-Mackay between three groups four and eight weeks after the

关 键 词：鼻窦炎伴鼻息肉 慢性 康复新液 鼻腔冲洗 内镜鼻窦手术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]