注射用七叶皂苷钠对慢性鼻-鼻窦炎术后黏膜恢复的影响
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摘要
目的:观察注射用七叶皂苷钠对慢性鼻-鼻窦炎患者术后临床症状、体征及鼻腔、窦腔黏膜上皮变化的影响。方法:选择本院2015年7月-2016年6月收治的慢性鼻窦炎患者80例,按照随机数字表法将患者分为试验组和对照组,各40例。试验组在常规术后治疗的基础上静脉滴注七叶皂苷钠,对照组在常规术后治疗的基础上静脉滴注地塞米松。两组均根据术区恢复情况制定个性化定期复查,随诊3个月。结果:试验组填塞物抽出后鼻腔出血情况明显优于对照组,差异有统计学意义(Z=-2.785,P=0.005);试验组抽出填塞物后3 d黏膜水肿情况明显轻于对照组,差异有统计学意义(P<0.05);试验组鼻黏膜水肿平均消退时间短于对照组,差异有统计学意义(Z=-2.959,P=0.003);试验组无症状例数明显多于对照组,差异有统计学意义(x~2=5.591,P=0.018);试验组治愈率明显高于对照组,差异有统计学意义(x~2=4.588,P=0.032),但两组的总有效率比较,差异无统计学意义(P>0.05)。结论:在慢性鼻-鼻窦炎术后常规治疗的基础上加用七叶皂苷钠,可减少鼻腔粘连、出血,减轻黏膜炎性反应和水肿,缩短水肿消退时间,促进术腔上皮化,明显提高疗效。
Objective:To observe the effect of the Sodium Aescinate for Injection on the symptoms,signs and the changes of nasal mucosa in patients with chronic nasal sinusitis after endoscopic sinus surgery.Method:From July 2015 to June 2016,80 patients with chronic sinustis admitted into our hospital were selected,patients were divided into experimental group and control group,40 cases in each group.The experimental group was treated with intravenous infusion of Sodium Aescinate for Injection on the basis of routine postoperative treatment,the control group was treated with intravenous drip of Dexamethasone on the basis of routine postoperative treatment.According to the recovery of the two groups,the individual periodic reexamination was made,and the followup was 3 months.Result:The hemorrhage of the nasal cavity in the experimental group was significantly better than that of the control group, the difference was statistically significant(Z=-2.785,P=0.005);the 3 d mucous membrane edema in the experimental group was significantly lighter than that in the control group,the difference was statistically significant(Z=-2.959,P=0.003);the average regression time of nasal edema in the experimental group was shorter than that in the control group,the difference was statistically significant(P<0.05);the number of asymptomatic cases in the experimental group was obviously more than that of the control group,the difference was statistically significant( x~2=5.591,P=0.018);the cure rate of the experimental group was significantly higher than that of the control group,the difference was statistically significant( x~2=4.588,P=0.032),but there was no significant difference in the total effective rate between the two groups(P>0.05).Conclusion:Sodium Aescinate for Injection is added on the basis of conventional treatment for chronic rhinosinusitis,it can reduce nasal adhesion,bleeding,relieve mucous inflammatory reaction and edema,shorten the time of edema and decline,promote the epithelialization of the operation cavity,and improve the curative effect obviously.
Objective:To observe the effect of the Sodium Aescinate for Injection on the symptoms,signs and the changes of nasal mucosa in patients with chronic nasal sinusitis after endoscopic sinus surgery.Method:From July 2015 to June 2016,80 patients with chronic sinustis admitted into our hospital were selected,patients were divided into experimental group and control group,40 cases in each group.The experimental group was treated with intravenous infusion of Sodium Aescinate for Injection on the basis of routine postoperative treatment,the control group was treated with intravenous drip of Dexamethasone on the basis of routine postoperative treatment.According to the recovery of the two groups,the individual periodic reexamination was made,and the followup was 3 months.Result:The hemorrhage of the nasal cavity in the experimental group was significantly better than that of the control group, the difference was statistically significant(Z=-2.785,P=0.005);the 3 d mucous membrane edema in the experimental group was significantly lighter than that in the control group,the difference was statistically significant(Z=-2.959,P=0.003);the average regression time of nasal edema in the experimental group was shorter than that in the control group,the difference was statistically significant(P<0.05);the number of asymptomatic cases in the experimental group was obviously more than that of the control group,the difference was statistically significant( x~2=5.591,P=0.018);the cure rate of the experimental group was significantly higher than that of the control group,the difference was statistically significant( x~2=4.588,P=0.032),but there was no significant difference in the total effective rate between the two groups(P>0.05).Conclusion:Sodium Aescinate for Injection is added on the basis of conventional treatment for chronic rhinosinusitis,it can reduce nasal adhesion,bleeding,relieve mucous inflammatory reaction and edema,shorten the time of edema and decline,promote the epithelialization of the operation cavity,and improve the curative effect obviously.
引文
[1]谢朝峰,林宏浩.慢性鼻-鼻窦炎手术预后的临床影响因素分析[J].山东大学耳鼻喉眼学报,2016,30(4):90-92.
[2]韩德民,周兵.鼻内镜外科学[M].北京:人民卫生出版社,2012:42.
[3]张小青,冯益进,徐永田,等.鼻内镜治疗慢性鼻-鼻窦炎围手术期的临床观察[J].中国中西医结合耳鼻咽喉科杂志,2017,25(1):44-45.
[4]刘小飞,庐健.鼻内镜治疗慢性鼻窦炎前后患者鼻黏膜形态与功能变化的研究[J].中国当代医药,2016,23(8):104-106.
[5]史先萍,周本忠,王胜国,等.慢性鼻-鼻窦炎的药物治疗与功能性内镜鼻窦手术+药物综合治疗的疗效比较[J].中国中西医结合耳鼻咽喉科杂志,2015,23(5):335-339.
[6]吴青松,邹志卢,永田,等.慢性鼻-鼻窦炎患者鼻内镜手术前后生存质量及相关研究[J].中国医学创新,2017,14(24):37-40.
[7]王艳,张庆泉,宋瑞英,等.鼻内镜手术后并发空窦综合征41例并文献复习[J].山东大学耳鼻喉眼学报,2015,29(2):55-57.
[8]曹长兴,杨秀海,彭维晖,等.鼻内镜下治疗上鼻道窦口复合区病变50例[J].临床耳鼻咽喉头颈外科杂志,2017,31(7):559-562.
[9]王明婕,林枫,张晓晴,等.功能性鼻内镜手术与轮廓化鼻内镜手术治疗难治性鼻窦炎的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2017,31(3):185-190.
[10]高振峰,陶谦,蔡晓岚,等.ERK5蛋白在鼻息肉细胞中的表达和意义[J].山东大学耳鼻咽喉眼学报,2016,30(1):40-42,46.
[11]许海波,洪燕丽,李兆生,等.鼻内镜术后不同填塞材料对术后黏膜转归的影响[J].山东大学耳鼻喉眼学报,2016,30(5):75-87.
[12]中华医学会耳鼻咽喉科学分会,中华耳鼻咽喉科杂志编辑委员会.慢性鼻窦炎鼻息肉临床分型分期内镜鼻窦手术疗效评定标准(1997年,海口)[J].中华耳鼻咽喉科杂志,1998,33(8):134.
[13]赵颖,王利军,贾文学,等.止血海绵内注入庆大霉素、地塞米松对鼻内镜术后疗效观察[J].河北医药,2014,36(17):243-245.
[14]胡伟琦,单雅敏,郝立娜,等.功能性鼻内镜鼻窦手术后纳吸棉鼻腔填塞效果评估[J].临床耳鼻咽喉头颈外科杂志,2016,30(18):1438-1443.
[15]王明甫.鼻内镜手术治疗慢性鼻窦炎后症状无缓解的处理与相关因素分析[J].中国现代手术学杂志,2014,18(6):469-470.
[16]古庆家,李静娴,樊建刚,等.修正性鼻内镜手术治疗复发性慢性鼻-鼻窦炎的临床分析[J].临床耳鼻咽喉头颈外科杂志,2015,29(9):800-803.
[17]马明忠,周霞伊,纪亮,等.慢性鼻-鼻窦炎鼻内镜术后鼻腔粘连的预防及处理探讨[J].中国中西医结合耳鼻咽喉科杂志,2017,25(4):276-277.
[18]许庚,李源,谢民强,等.功能性内窥镜鼻窦手术后术腔粘膜转归阶段的划分及处理原则[J].中华耳鼻咽喉头颈外科杂志,1999,34(5):302-305.
[19]张学东.功能性鼻内镜手术治疗慢性鼻窦炎78例临床疗效观察[J].四川医学,2013,34(6):898-899.
[20]林文盛.七叶皂苷钠与地塞米松治疗急性面神经炎的对照研究[J].海峡药学,2004,16(4):108-109.
[2]韩德民,周兵.鼻内镜外科学[M].北京:人民卫生出版社,2012:42.
[3]张小青,冯益进,徐永田,等.鼻内镜治疗慢性鼻-鼻窦炎围手术期的临床观察[J].中国中西医结合耳鼻咽喉科杂志,2017,25(1):44-45.
[4]刘小飞,庐健.鼻内镜治疗慢性鼻窦炎前后患者鼻黏膜形态与功能变化的研究[J].中国当代医药,2016,23(8):104-106.
[5]史先萍,周本忠,王胜国,等.慢性鼻-鼻窦炎的药物治疗与功能性内镜鼻窦手术+药物综合治疗的疗效比较[J].中国中西医结合耳鼻咽喉科杂志,2015,23(5):335-339.
[6]吴青松,邹志卢,永田,等.慢性鼻-鼻窦炎患者鼻内镜手术前后生存质量及相关研究[J].中国医学创新,2017,14(24):37-40.
[7]王艳,张庆泉,宋瑞英,等.鼻内镜手术后并发空窦综合征41例并文献复习[J].山东大学耳鼻喉眼学报,2015,29(2):55-57.
[8]曹长兴,杨秀海,彭维晖,等.鼻内镜下治疗上鼻道窦口复合区病变50例[J].临床耳鼻咽喉头颈外科杂志,2017,31(7):559-562.
[9]王明婕,林枫,张晓晴,等.功能性鼻内镜手术与轮廓化鼻内镜手术治疗难治性鼻窦炎的疗效分析[J].临床耳鼻咽喉头颈外科杂志,2017,31(3):185-190.
[10]高振峰,陶谦,蔡晓岚,等.ERK5蛋白在鼻息肉细胞中的表达和意义[J].山东大学耳鼻咽喉眼学报,2016,30(1):40-42,46.
[11]许海波,洪燕丽,李兆生,等.鼻内镜术后不同填塞材料对术后黏膜转归的影响[J].山东大学耳鼻喉眼学报,2016,30(5):75-87.
[12]中华医学会耳鼻咽喉科学分会,中华耳鼻咽喉科杂志编辑委员会.慢性鼻窦炎鼻息肉临床分型分期内镜鼻窦手术疗效评定标准(1997年,海口)[J].中华耳鼻咽喉科杂志,1998,33(8):134.
[13]赵颖,王利军,贾文学,等.止血海绵内注入庆大霉素、地塞米松对鼻内镜术后疗效观察[J].河北医药,2014,36(17):243-245.
[14]胡伟琦,单雅敏,郝立娜,等.功能性鼻内镜鼻窦手术后纳吸棉鼻腔填塞效果评估[J].临床耳鼻咽喉头颈外科杂志,2016,30(18):1438-1443.
[15]王明甫.鼻内镜手术治疗慢性鼻窦炎后症状无缓解的处理与相关因素分析[J].中国现代手术学杂志,2014,18(6):469-470.
[16]古庆家,李静娴,樊建刚,等.修正性鼻内镜手术治疗复发性慢性鼻-鼻窦炎的临床分析[J].临床耳鼻咽喉头颈外科杂志,2015,29(9):800-803.
[17]马明忠,周霞伊,纪亮,等.慢性鼻-鼻窦炎鼻内镜术后鼻腔粘连的预防及处理探讨[J].中国中西医结合耳鼻咽喉科杂志,2017,25(4):276-277.
[18]许庚,李源,谢民强,等.功能性内窥镜鼻窦手术后术腔粘膜转归阶段的划分及处理原则[J].中华耳鼻咽喉头颈外科杂志,1999,34(5):302-305.
[19]张学东.功能性鼻内镜手术治疗慢性鼻窦炎78例临床疗效观察[J].四川医学,2013,34(6):898-899.
[20]林文盛.七叶皂苷钠与地塞米松治疗急性面神经炎的对照研究[J].海峡药学,2004,16(4):108-109.