功能性内镜鼻窦手术联合鼻窦炎合剂冲洗对慢性鼻-鼻窦炎患者鼻黏膜纤毛功能及生活质量的影响
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摘要
目的探讨功能性内镜鼻窦手术(FESS)联合鼻窦炎合剂冲洗对慢性鼻-鼻窦炎(CRS)患者鼻黏膜纤毛功能及生活质量的影响。方法选取90例接受FESS手术的CRS患者,随机分为观察组(n=45)和对照组(n=45)。观察组术后采用鼻窦炎合剂进行术腔冲洗,对照组采用复方氯化钠注射液。比较2组临床疗效、术后术腔清洁时间、术腔上皮化时间及治疗前后纤毛细胞数目/杯状细胞数目比值、鼻腔黏膜纤维传输速率(MTR)、鼻内镜Lund-Kennedy评分、鼻部症状视觉模拟(VAS)评分及鼻腔鼻窦结局测试-20量表(SNOT-20)评分。结果观察组总有效率显著高于对照组(P <0. 05)。观察组术后术腔清洁时间、术腔上皮化时间均显著短于对照组(P <0. 05)。术后6个月,观察组纤毛细胞数目/杯状细胞数目比值、MTR均显著高于对照组(P <0. 05),鼻内镜Lund-Kennedy评分、鼻部症状VAS评分及SNOT-20评分均显著低于对照组(P <0. 05)。结论鼻窦炎合剂能够改善FESS术后患者鼻黏膜纤毛功能,促进患者症状缓解,提高生活质量。
Objective To explore the influence of functional endoscopic sinus surgery( FESS) combined with sinusitis flushing on nasal mucociliary function and quality of life in patients with chronic rhinosinusitis( CRS). Methods A total of 90 CRS patients with FESS were randomly divided into observation group( n = 45) and control group( n = 45). The sinusitis mixture was used in the observation group,while the recurrent sodium chloride was used in the control group. The clinical efficacy,postoperative cavity cleaning time,intra-operative epithelialization time,the ratio of the number of ciliated cells to goblet cell number before and after treatment,nasal mucosal fiber transmission rate( MTR),nasal endoscopic Lund-Kennedy score,nasal symptom visual simulation score( VAS) and nasal sinus outcome test-20 scale( SNOT-20) score were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group( P < 0. 05). The postoperative cavity cleaning time and intra-operative epithelialization time in the observation group were significantly shorter than those in the control group( P <0. 05). At 6 months after operation,the ratio of the number of ciliated cells to the number of goblet cells and MTR in the observation group were significantly higher than those in the control group( P <0. 05),and the endoscopic Lund-Kennedy score,nasal symptom VAS score and SNOT-20 score were significantly lower than those in the control group( P < 0. 05). Conclusion Sinusitis mixture can improve the nasal mucociliary function of patients with FESS relieue symptoms and improve the quality of life.
Objective To explore the influence of functional endoscopic sinus surgery( FESS) combined with sinusitis flushing on nasal mucociliary function and quality of life in patients with chronic rhinosinusitis( CRS). Methods A total of 90 CRS patients with FESS were randomly divided into observation group( n = 45) and control group( n = 45). The sinusitis mixture was used in the observation group,while the recurrent sodium chloride was used in the control group. The clinical efficacy,postoperative cavity cleaning time,intra-operative epithelialization time,the ratio of the number of ciliated cells to goblet cell number before and after treatment,nasal mucosal fiber transmission rate( MTR),nasal endoscopic Lund-Kennedy score,nasal symptom visual simulation score( VAS) and nasal sinus outcome test-20 scale( SNOT-20) score were compared between the two groups. Results The total effective rate of the observation group was significantly higher than that of the control group( P < 0. 05). The postoperative cavity cleaning time and intra-operative epithelialization time in the observation group were significantly shorter than those in the control group( P <0. 05). At 6 months after operation,the ratio of the number of ciliated cells to the number of goblet cells and MTR in the observation group were significantly higher than those in the control group( P <0. 05),and the endoscopic Lund-Kennedy score,nasal symptom VAS score and SNOT-20 score were significantly lower than those in the control group( P < 0. 05). Conclusion Sinusitis mixture can improve the nasal mucociliary function of patients with FESS relieue symptoms and improve the quality of life.
引文
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[2]李达深.甲泼尼松与泼尼松对慢性鼻窦炎鼻息肉患者鼻内镜手术后鼻黏膜功能及生活质量的影响对比[J].中国老年学杂志,2015,35(23):6888-6889.
[3]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组.慢性鼻-鼻窦炎诊断和治疗指南(2012年,昆明)[J].中华耳鼻咽喉头颈外科杂志,2013,48(2):92-94.
[4]中华医学会耳鼻喉科学分会,中华耳鼻喉科学杂志编辑委员会.慢性鼻窦炎鼻息肉临床分型分期及内窥镜鼻窦手术疗效评定标准(1997年,海口)[J].中华耳鼻咽喉头颈外科杂志,1998,33(3):134-135.
[5]罗伟,文科,邓玫,等.DIP内镜评分方案在评价行鼻内镜手术的慢性鼻-鼻窦炎患者病情方面的应用[J].中国内镜杂志,2016,22(5):65-69.
[6]左可军,方积乾,Piccirillo J F,等.鼻腔鼻窦结局测试-20(SNOT-20)量表中文版的研制[J].中华耳鼻咽喉头颈外科杂志,2008,43(10):751-756.
[7]Rittschof C C,Pattanaik S,Johnson L,et al.European Position Paper on Rhinosinusitis and Nasal Polyps 2012:Updates and highlights on diagnosis and treatment of rhinosinusitis[J].Medical Journal of Chinese Peoples Liberation Army,2013,38(2):87-93.
[8]魏群,张同威,韩宪伟,等.中药雾化对慢性鼻-鼻窦炎鼻内镜术后恢复及鼻黏膜炎症细胞的影响[J].现代中西医结合杂志,2017,26(33):3729-3731.
[9]周昕,赵颜俐,刘学良,等.中药鼻腔灌洗对非侵袭性真菌性鼻窦炎术后的临床疗效[J].中国微生态学杂志,2017,29(1):82-84.
[10]侯小兵,夏晶晶,王君,等.难治性鼻窦炎鼻内镜手术联合中药"苍耳子散"应用78例疗效观察[J].中国中西医结合耳鼻咽喉科杂志,2017,25(2):150-152.
[11]李良波,龚成,廖勇,等.清窦灵合剂治疗慢性鼻-鼻窦炎鼻内镜术后患者临床研究[J].时珍国医国药,2015,26(4):922-924.
[12]Dhong H J,Kim H Y,Cho D Y.Histopathologic characteristics of chronic sinusitis with bronchial asthma.[J].Acta Otolaryngol,2005,125(2):169-176.
[13]袁晖,杨蓓蓓,魏红权.鼻息肉组织中杯状细胞密度与术后疗效的相关性分析[J].临床耳鼻咽喉头颈外科杂志,2008,22(11):518-519.
[14]雍军,王咏峰.鼻渊通窍颗粒联合曲安奈德鼻喷雾剂治疗慢性鼻-鼻窦炎的临床观察[J].中国药房,2016,27(20):2795-2797.
[2]李达深.甲泼尼松与泼尼松对慢性鼻窦炎鼻息肉患者鼻内镜手术后鼻黏膜功能及生活质量的影响对比[J].中国老年学杂志,2015,35(23):6888-6889.
[3]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组.慢性鼻-鼻窦炎诊断和治疗指南(2012年,昆明)[J].中华耳鼻咽喉头颈外科杂志,2013,48(2):92-94.
[4]中华医学会耳鼻喉科学分会,中华耳鼻喉科学杂志编辑委员会.慢性鼻窦炎鼻息肉临床分型分期及内窥镜鼻窦手术疗效评定标准(1997年,海口)[J].中华耳鼻咽喉头颈外科杂志,1998,33(3):134-135.
[5]罗伟,文科,邓玫,等.DIP内镜评分方案在评价行鼻内镜手术的慢性鼻-鼻窦炎患者病情方面的应用[J].中国内镜杂志,2016,22(5):65-69.
[6]左可军,方积乾,Piccirillo J F,等.鼻腔鼻窦结局测试-20(SNOT-20)量表中文版的研制[J].中华耳鼻咽喉头颈外科杂志,2008,43(10):751-756.
[7]Rittschof C C,Pattanaik S,Johnson L,et al.European Position Paper on Rhinosinusitis and Nasal Polyps 2012:Updates and highlights on diagnosis and treatment of rhinosinusitis[J].Medical Journal of Chinese Peoples Liberation Army,2013,38(2):87-93.
[8]魏群,张同威,韩宪伟,等.中药雾化对慢性鼻-鼻窦炎鼻内镜术后恢复及鼻黏膜炎症细胞的影响[J].现代中西医结合杂志,2017,26(33):3729-3731.
[9]周昕,赵颜俐,刘学良,等.中药鼻腔灌洗对非侵袭性真菌性鼻窦炎术后的临床疗效[J].中国微生态学杂志,2017,29(1):82-84.
[10]侯小兵,夏晶晶,王君,等.难治性鼻窦炎鼻内镜手术联合中药"苍耳子散"应用78例疗效观察[J].中国中西医结合耳鼻咽喉科杂志,2017,25(2):150-152.
[11]李良波,龚成,廖勇,等.清窦灵合剂治疗慢性鼻-鼻窦炎鼻内镜术后患者临床研究[J].时珍国医国药,2015,26(4):922-924.
[12]Dhong H J,Kim H Y,Cho D Y.Histopathologic characteristics of chronic sinusitis with bronchial asthma.[J].Acta Otolaryngol,2005,125(2):169-176.
[13]袁晖,杨蓓蓓,魏红权.鼻息肉组织中杯状细胞密度与术后疗效的相关性分析[J].临床耳鼻咽喉头颈外科杂志,2008,22(11):518-519.
[14]雍军,王咏峰.鼻渊通窍颗粒联合曲安奈德鼻喷雾剂治疗慢性鼻-鼻窦炎的临床观察[J].中国药房,2016,27(20):2795-2797.