鼻内镜术后高渗盐水鼻腔冲洗治疗慢性鼻窦炎的临床疗效

Xuexing Zhang, Kuishan Zhang, Shujun Sun
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摘要

目的探讨慢性鼻窦炎内镜术后高渗盐水鼻腔冲洗的临床疗效。方法选择2014年5月~ 2017年3月新乡市第二人民医院诊断为慢性鼻窦炎的患者104例,按分层随机法分为常规组和观察组。所有患者均行功能性鼻窦内镜手术,术后给予相应的抗生素和糖皮质激素。常规组给予生理盐水冲洗,观察组给予高渗生理盐水洗鼻。并根据患者术后恢复情况减少剂量,术后6个月随访患者。观察两组患者术后腔内黏膜改善情况及临床症状,记录手术腔粘膜上皮化时间,统计两组患者随访期间不良反应发生情况。结果常规组总有效率明显低于观察组(76.9% vs. 92.3%, P < 0.05)。常规组12周粘膜上皮化时间组成比分别为1.9%、25.0%、46.2%、26.9%,观察组分别为3.8%、51.9%、26.9%、17.3%,均显著短于常规组(P<0.05)。两组患者均未出现不良反应。结论高渗盐水鼻窦冲洗可显著提高内镜手术的手术疗效,促进鼻黏膜功能恢复,安全性高。关键词:鼻窦灌洗;慢性鼻窦炎
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Clinical efficacy of hypertonic saline nasal sinus irrigation after endoscopic surgery for chronic rhinosinusitis
Objective To explore the clincal efficacy of hypertonic saline nasal sinus irrigation after endoscopic surgery for chronic rhinosinusitis. Methods A total of 104 patients diagnosed as chronic rhinosinusitis in the Second People’s Hospital of Xinxiang from May 2014 to March 2017 were selected and divided into routine group and observation group according to the stratified random method. And all patients were given functional endoscopic sinus surgery and then given the corresponding antibiotics and glucocorticoids after operation. The routine group was given normal saline for irrigation, and observation group was given hypertonic saline for nasal sinus lavage. And their dosages was reduced according to the patients’ postoperative recovery, and patients were followed up at 6 months after operation. The improvements of postoperative luminal mucosa and clinical symptoms were observed in the two groups, and the mucosal epithelialization time of the surgical cavity was recorded, and the occurrence of adverse reactions during the follow-up was counted in the two groups. Results The total effective rate in routine group was significantly lower than that in observation group (76.9% vs. 92.3%, P 0.05). The constituent ratios of the mucosal epithelialization time 12 weeks were 1.9%, 25.0%, 46.2% and 26.9%, respectively, in routine group, and they were 3.8%, 51.9%, 26.9% and 17.3% respectively in observation group, which were significantly shorter than those in routine group (P<0.05). And there were no adverse reactions in the two groups. Conclusions Hypertonic saline nasal sinus irrigation can significantly improve the surgical efficacy of endoscopic surgery, and promote the recovery of nasal mucosa function, with high safety. Key words: Nasal sinus lavage; Chronic rhinosinusitis
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