鼻内镜手术联合糖皮质激素浸润对慢性鼻窦炎 伴鼻息肉患者远期疗效及鼻功能的影响

Effects of endoscopic sinus surgery combined with glucocorticoid infiltration on long-term efficacy and nasal function in patients with chronic rhinosinusitis with nasal polyps

摘要:

目的 探究鼻内镜手术联合糖皮质激素浸润对慢性鼻窦炎伴鼻息肉（CRSwNP）患者远期疗效 及鼻功能的影响。方法 选取2015 年5 月—2018 年3 月安徽医科大学第二附属医院收治的112 例CRSwNP 患者作为研究对象，根据随机数表法分为联合组和对照组，每组56 例。对照组采用鼻内镜手术治疗，联合组 采用鼻内镜手术联合糖皮质激素浸润治疗。比较两组患者治疗前与治疗后2 个月的各项评分、鼻腔通气功能、 鼻黏液纤毛清除功能，并记录患者并发症与复发情况，分析其临床疗效。结果 联合组与对照组患者治疗前 后Lund-Mackey、SNOT-20 及Lund-Kenndey 评分的差值比较，差异有统计学意义（P <0.05）。联合组患者 并发症发生率和复发率分别为5.36% 和3.57%，对照组分别为12.50% 和8.93%，联合组患者并发症发生率和 复发率低于对照组（P <0.05）。联合组与对照组治疗总有效率分别为92.86% 和83.93%，经χ2 检验，差异有 统计学意义（P <0.05）。联合组与对照组治疗前后鼻腔通气功能指标、鼻黏液纤毛清除功能指标的差值比较， 差异有统计学意义（P <0.05）。结论 鼻内镜手术联合糖皮质激素浸润治疗CRSwNP 的疗效显著，可明显改 善患者的临床症状、鼻腔通气功能及鼻黏液纤毛清除功能，并发症少，复发率低，值得临床推广应用。

Abstract:

Objective To investigate the effects of endoscopic sinus surgery combined with glucocorticoid infiltration on long-term efficacy and nasal function in patients with chronic rhinosinusitis with nasal polyps. Methods From May 2015 to March 2018, 112 patients with chronic rhinosinusitis and nasal polyps in our hospital were selected as the study subjects. According to the random number table method, they were divided into the combined group and the control group, 56 cases in each group. The control group was treated with endoscopic surgery, and the combined group was treated with endoscopic surgery combined with glucocorticoid infiltration. The scores of the two groups before and 2 months after treatment, nasal ventilation function, nasal mucociliary clearance, and complications and recurrence were recorded. The clinical efficacy was analyzed. Results After treatment, the difference in Lund-Mackey, SNOT-20, and Lund-Kenndey scores between the patients in the combined group and the control group was statistically significant (P < 0.05); the complication rate and recurrence rate in the combined group were 5.36% and 3.57%, respectively. The complication rate and recurrence rate of the control group were 12.50% and 8.93%, respectively, and the differences were statistically significant (P < 0.05); the complication rate and recurrence rate in the combined group were lower than the total effective rate of the control group in the combined group of 92.86%, and the total effective rate of the control group was 83.93%, the difference was statistically significant (P < 0.05); after treatment, the difference between the nasal ventilation function index of the combination group and the control group was statistically significant (P < 0.05); the differences of the nasal mucociliary clearance function index of the combination group after treatment were compared with the control group by t test, and the difference was statistically significant (P < 0.05). Conclusion Endoscopic surgery combined with glucocorticoid infiltration for the treatment of chronic rhinosinusitis with nasal polyps is effective, can significantly improve the patient’s clinical symptoms, nasal ventilation function and nasal mucociliary clearance function, and has less complications and lower recurrence rate, which is worthy of clinical promotion.