鼻内镜术中布地奈德混悬液浸润对慢性鼻-鼻窦炎患者术后焦虑情绪及鼻腔相关功能恢复的影响
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摘要
目的:探讨鼻内镜手术应用布地奈德混悬液浸润对慢性鼻-鼻窦炎(CRS)患者术后焦虑情绪及鼻腔相关功能恢复的影响。方法:随机数字表格法将120例CRS患者分为观察组与对照组各60例,观察组于鼻内镜手术完成时将含有布地奈德混悬液浸润的明胶海绵置入中鼻道,对照组仅放置明胶海绵(不含药物),比较两组治疗前后视觉模拟评分(VAS)、鼻窦CT评分、鼻黏膜纤毛功能及焦虑自评量表(SAS)情况。结果:观察组术后4周总体症状VAS评分、鼻窦CT评分、SAS评分均显著低于对照组,差异有统计学意义(t=-2.590,-3.548,-5.735;P<0.05);黏膜纤毛清除率、黏膜纤毛清除速度及糖精清除时间方面,观察组均显著优于对照组(t=5.336,3.828,-7.131;P<0.05)。结论 :鼻内镜手术应用布地奈德混悬液浸润能明显改善CRS患者术后鼻黏膜纤毛功能及鼻部症状,术后焦虑情绪显著轻。
Objective:To investigate the effect of budesonide suspension infiltration on anxiety and recovery of nasal related function in patients with chronic rhinosinusitis(CRS)after nasal endoscopic surgery.Methods:A total of 120 patients with CRS were divided into the observation group and the control group by random number table method with 60 patients in each group.In the observation group,the gelatin sponge impregnated with budesonide suspension was placed in the middle meatus of patients at the end of nasal endoscopic surgery,while in the control group,only gelatin sponge(without drugs)was placed.The visual analogue scale(VAS)scores,sinus CT scores,nasal mucociliary function and the self rating Anxiety Scale(SAS)scores were compared between the two groups before and after treatment.Results:The overall VAS score,sinus CT score and SAS score of the observation group were significantly lower than those of the control group at 4 weeks after surgery(t=-2.590,-3.548,-5.735;P<0.05).The mucociliary clearance rate,mucociliary clearance speed and saccharin clearance time in the observation group were significantly better than those in the control group(t=5.336,3.828,-7.131;P<0.05).Conclusion:The use of budesonide suspension infiltration can obviously improve the nasal mucociliary function and relieve nasal symptoms in patients with CRS after nasal endoscopic surgery,and the degree of anxiety after surgery is mild.
Objective:To investigate the effect of budesonide suspension infiltration on anxiety and recovery of nasal related function in patients with chronic rhinosinusitis(CRS)after nasal endoscopic surgery.Methods:A total of 120 patients with CRS were divided into the observation group and the control group by random number table method with 60 patients in each group.In the observation group,the gelatin sponge impregnated with budesonide suspension was placed in the middle meatus of patients at the end of nasal endoscopic surgery,while in the control group,only gelatin sponge(without drugs)was placed.The visual analogue scale(VAS)scores,sinus CT scores,nasal mucociliary function and the self rating Anxiety Scale(SAS)scores were compared between the two groups before and after treatment.Results:The overall VAS score,sinus CT score and SAS score of the observation group were significantly lower than those of the control group at 4 weeks after surgery(t=-2.590,-3.548,-5.735;P<0.05).The mucociliary clearance rate,mucociliary clearance speed and saccharin clearance time in the observation group were significantly better than those in the control group(t=5.336,3.828,-7.131;P<0.05).Conclusion:The use of budesonide suspension infiltration can obviously improve the nasal mucociliary function and relieve nasal symptoms in patients with CRS after nasal endoscopic surgery,and the degree of anxiety after surgery is mild.
引文
[1]程继明,刘亚峰,文林,等.克拉霉素联合布地奈德应用对儿童鼻-鼻窦炎的疗效观察[J].西部医学,2012,24(5):879-881+885
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[6]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.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
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[12]Murr A H,Smith T L,Hwang P H,et al.Safety and efficacy of a novel bioabsorbable,steroid-eluting sinus stent[J].Int Forum Allergy Rhinol,2011,1(1):23-32
[13]陈晓栋,王海婷,石照辉,等.慢性鼻-鼻窦炎内镜手术应用布地奈德混悬液中鼻道浸润的长期疗效观察[J].临床耳鼻咽喉头颈外科杂志,2016,30(3):203-205+208
[14]Felger J C,Lotrich F E.Inflammatory cytokines in depression:Neurobiological mechanisms and therapeutic implications[J].Neuroscience,2013,246(29):199-229
[15]Calderon M,Devalia J,Prior A,et al.A comparison of cytokine release from epithelial cells cultured from nasal biopsy specimens of atopic patients with and without rhinitis and nonatopic subjects without rhinitis[J].J Allergy Clin Immunol,1997,99(1Pt 1):65-76
[16]韩桐师,王丹辉,万憬,等.心理因素对不同种类疾病慢性疼痛的影响[J].中国健康心理学杂志,2013,21(11):1651-1653
[17]张永芬,杨炳丽.心理干预对患者术后焦虑与疼痛的影响[J].中国健康心理学杂志,2011,19(2):174-175
[18]王雅儒.专职护理干预对鼻内镜下手术治疗鼻窦炎与鼻息肉患者并发症及心理情绪的影响[J].国际护理学杂志,2016,35(17):2407-2409
[2]杨红丽,冯蓉,安丽,等.布地奈德联合克拉霉素治疗慢性鼻-鼻窦炎疗效观察以及对黏膜组织重塑的影响[J].中国耳鼻咽喉颅底外科杂志,2017,24(2):99-102
[3]刘艺昌,尹昕.老年慢性鼻-鼻窦炎鼻息肉患者行功能性鼻内镜鼻窦手术的疗效和安全性[J].中国老年学杂志,2014,34(14):4034-4035
[4]刘学良,雷刚.鼻内镜手术后使用布地奈德鼻喷雾剂治疗慢性鼻-鼻窦炎伴变应性鼻炎的临床观察[J].中国药房,2017,28(2):215-219
[5]张卫拾,高刚,钱茂华,等.功能性鼻内镜鼻窦手术后换药应用布地奈德混悬液的效果分析[J].山东大学耳鼻喉眼学报,2014,28(4):43-45
[6]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.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
[7]Lund V J,Kennedy D W.Staging for rhinosinusitis[J].Otolaryngol Head Neck Surg,1997,117(3Pt2):S35-40
[8]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
[9]田大清,许菲莎.鼻内镜术后康复新联合布地奈德的近期疗效研究[J].皖南医学院学报,2016,35(2):151-153
[10]万丽红,王志敏,王菲菲,等.布地奈德鼻腔雾化在功能性鼻内镜手术后的应用及疗效观察[J].护理实践与研究,2015,12(8):90-91
[11]AL-Mutairid,Kilty S J.Bacterial biofilms and the pathophysiology of ch-ronic rhinosinusitis[J].Curr Opin Allergy Clin Immunol,2011,11(1):18-23
[12]Murr A H,Smith T L,Hwang P H,et al.Safety and efficacy of a novel bioabsorbable,steroid-eluting sinus stent[J].Int Forum Allergy Rhinol,2011,1(1):23-32
[13]陈晓栋,王海婷,石照辉,等.慢性鼻-鼻窦炎内镜手术应用布地奈德混悬液中鼻道浸润的长期疗效观察[J].临床耳鼻咽喉头颈外科杂志,2016,30(3):203-205+208
[14]Felger J C,Lotrich F E.Inflammatory cytokines in depression:Neurobiological mechanisms and therapeutic implications[J].Neuroscience,2013,246(29):199-229
[15]Calderon M,Devalia J,Prior A,et al.A comparison of cytokine release from epithelial cells cultured from nasal biopsy specimens of atopic patients with and without rhinitis and nonatopic subjects without rhinitis[J].J Allergy Clin Immunol,1997,99(1Pt 1):65-76
[16]韩桐师,王丹辉,万憬,等.心理因素对不同种类疾病慢性疼痛的影响[J].中国健康心理学杂志,2013,21(11):1651-1653
[17]张永芬,杨炳丽.心理干预对患者术后焦虑与疼痛的影响[J].中国健康心理学杂志,2011,19(2):174-175
[18]王雅儒.专职护理干预对鼻内镜下手术治疗鼻窦炎与鼻息肉患者并发症及心理情绪的影响[J].国际护理学杂志,2016,35(17):2407-2409