全降解鼻窦药物支架系统治疗伴鼻息肉的慢性鼻窦炎的疗效及术后恢复效果分析

Analysis of fully biodegradable sinus drug stents on efficacy and postoperative recovery in patients with chronic rhinosinusitis with nasal polyps

摘要:

目的 探讨全降解鼻窦药物支架系统治疗伴鼻息肉的慢性鼻窦炎（CRSwNP）患者的临床疗效及术后恢复效果。方法 选取2022年8月—2024年10月在榆林市中医医院接受鼻内镜手术治疗的120例CRSwNP患者，采用随机数字表法分为观察组和对照组，各60例。两组患者均接受鼻内镜手术治疗，观察组在手术结束前植入全降解鼻窦药物支架系统，对照组术后采用布地奈德鼻腔冲洗与喷雾治疗。术后评估两组患者症状改善时间、术后并发症情况、复发率及临床疗效，比较两组手术前后的鼻腔结构、鼻气道阻力、鼻窦CT评分及鼻内镜各项评分。结果 观察组患者的术后恢复通气时间、鼻黏膜恢复时间及住院时长均短于对照组（P <0.05）。观察组治疗前后的Lund-Mackay评分、息肉评分、水肿评分和鼻腔分泌物评分的差值及治疗后瘢痕/结痂评分均低于对照组（P <0.05）。观察组术后并发症发生率和复发率均低于对照组（P <0.05），总有效率高于对照组（P <0.05）。结论 全降解鼻窦药物支架系统对CRSwNP有显著的临床疗效，可加快术后恢复，降低术后并发症和复发率，具有较高的临床应用价值。

Abstract:

Objective To investigate the efficacy and postoperative recovery of fully biodegradable sinus drug stents in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).Methods A total of 120 CRSwNP patients who underwent endoscopic sinus surgery at our hospital between August 2022 and October 2024 were selected and randomly divided into two groups, the observation group and the control group, with 60 patients in each group. Both groups underwent endoscopic sinus surgery. The observation group received the implantation of fully biodegradable sinus drug stents before the end of the surgery, while the control group received postoperative nasal irrigation and spray treatment with budesonide. Postoperative recovery was assessed by comparing symptom improvement time, postoperative complications, recurrence rate, and clinical effectiveness. Nasal structure, nasal airway resistance, Lund-Mackay sinus CT scores, and nasal endoscopy scores were compared between the two groups before and after treatment.Results The observation group showed shorter recovery time for nasal ventilation, mucosal recovery, and hospital stay compared to the control group (P < 0.05). The differences in Lund-Mackay scores, polyp scores, edema scores, and nasal secretion scores before and after treatment, as well as scarring/crusting scores post-treatment, were all lower in the observation group than in the control group (P < 0.05). The observation group had a lower incidence of postoperative complications and recurrence rates compared to the control group (P < 0.05), and a higher total effective rate (P < 0.05).Conclusion Fully biodegradable sinus drug stents have significant clinical effects in patients with chronic rhinosinusitis with nasal polyps. They accelerate postoperative recovery, reduce complications and recurrence rates, and have high clinical application value.