短期布地奈德混悬液经鼻雾化对慢性鼻窦炎伴鼻息肉手术出血的影响

doi:10.6040/j.issn.1673-3770.0.2015.311

摘要/Abstract

摘要： 目的评价短期应用布地奈德混悬液经鼻雾化对慢性鼻窦炎伴鼻息肉手术出血的影响。方法 96例慢性鼻窦炎伴鼻息肉患者随机分成A组33例、B组31例及C 组32例,A组术前7 d给予布地奈德混悬液经鼻雾化吸入及罗红霉素口服,B组给予布地奈德喷鼻剂喷鼻及罗红霉素口服,C组给予生理盐水鼻腔冲洗及罗红霉素口服。三组均在全麻气管插管下按统一方案手术。对比三组术中出血量及A、B组血清皮质醇浓度变化。结果 A、B、C三组患者术中平均出血量分别为(51.70±18.62)mL、(73.16±19.23)mL、(90.16±15.97)mL,三组间差异有统计学意义(F=37.34, P<0.01)。A组用药后血清皮质醇浓度降低(P<0.01),但在正常值范围内;B组用药前后血清皮质醇浓度无变化(P>0.05)。结论短期应用布地奈德混悬液经鼻雾化吸入,可减少慢性鼻窦炎伴鼻息肉患者鼻内镜术中出血,且对肾上腺皮质功能无明显影响。

关键词: 鼻息肉, 鼻内镜外科手术, 鼻窦炎, 布地奈德

Abstract: Objective To evaluate the effect of short-course budesonide suspension via nasal atomization on the operation bleeding of chronic nasosinusitis accompanied by nasal polyps. Methods A total of 96 patients with chronic nasosinusitis accompanied by nasal polyps were randomly divided into group A(n=33), group B(n=31)and group C(n=32). At 7 days before the operation, group A was inhaled budesonide suspension via nasal atomization and took roxithromycin; Group B was given budesonide nasal spray and took roxithromycin; Group C was given normal saline to wash the nasal cavity and took roxithromycin. The operations were performed in 3 groups according to the unified regimen. The amount of intraoperative bleeding in 3 groups and change of serum cortisol concentrations in groups A and B were compared. Results Average amount of intraoperative bleeding in 3 groups was(51.70±18.62)mL,(73.16±19.23)mL and(90.16±15.97)mL, and there was statistical significance among 3 groups(F=37.34, P<0.01). The concentration of serum cortisol in group A decreased after administration(P<0.01), but it was still within the normal range; There was no change in group B regarding the concentration of serum cortisol before and after administration(P>0.05). Conclusion Short-course application of budesonide suspension via nasal atomization can reduce endoscopic intraoperative bleeding of patients with chronic nasosinusitis accompanied by nasal polyp and has no obvious impact on the function of adrenal cortex.

Key words: Nasal endoscopic surgical procedures, operative, Nasal polyp, Nasosinusitis, Budesonide

中图分类号:

R765.2

郭艳红,马莎,王济生. 短期布地奈德混悬液经鼻雾化对慢性鼻窦炎伴鼻息肉手术出血的影响[J]. 山东大学耳鼻喉眼学报, 2016, 30(1): 51-53.

GUO Yanhong, MA Sha, WANG Jisheng. Effect of short-course budesonide suspension via nasal atomization on the operation bleeding of chronic nasosinusitis accompanied by nasal polyps.[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(1): 51-53.

参考文献

[1] Lund V J, Kennedy D W. Staging for rhinosinusitis[J]. Otolaryngol Head Neck Surg, 1997, 117(3 Pt 2): S35-S40.
[2] 中华耳鼻咽喉头颈外科杂志编委会, 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(2008年,南昌)[J]. 中华耳鼻咽喉头颈外科杂志, 2009, 44(1): 6-7.
[3] 史剑波, 杨钦泰, 文卫平, 等. 慢性鼻窦炎鼻息肉围手术前期处理对术中出血影响的观察[J]. 中华耳鼻咽喉科杂志, 2003, 38(3): 202-205. SHI Jianbo, YANG Qintai, WEN Weiping, et al. Study of bleeding during surgery of chronic sinusitis and nasal polyp influenced by preoperative treatment[J]. Chin J Otorhinolaryngol, 2003, 38(3):202-205.
[4] 邓享坤, 李学忠, 邱志宏, 等. 892例慢性鼻-鼻窦炎患者内镜鼻窦手术围手术期临床分析[J]. 山东大学耳鼻喉眼学报, 2009, 23(6): 45-48. DENG Xiangkun, LI Xuezhong, QIU Zhihong, et al. Clinical analysis on peri-operative medication for endoscopic sinus surgery of 892 cases of chronic rhinosinusitis[J]. J Otolaryngol Ophthal Shandong Univ, 2009, 23(6): 45-48.
[5] Fokkens W J, Lund V J, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists[J]. Rhinology, 2012, 50(1): 1-12.
[6] 徐丽娜, 栾建刚, 宋西成, 等. 高渗盐水普米克令舒治疗慢性鼻窦炎、鼻息肉 FESS术后复发[J]. 山东大学耳鼻喉眼学报, 2014, 28(3): 38-41. XU Lina, LUAN Jiangang, SONG Xicheng, et al. Hypertonic saline solution of pulmicort respules in post-operative recurrence of chronic sinusitis and nasal polyps after functional endoscopic sinus surgery[J]. J Otolaryngol Ophthal Shandong Univ, 2014, 28(3):38-41.
[7] Frank D O, Kimbell J S, Pawar S, et al. Effects of anatomy and particle size on nasal sprays and nebulizers[J]. Otolaryngol Head Neck Surg, 2012, 146(2): 313-319.
[8] 王成硕, 娄鸿飞, 娄玮, 等.短期布地奈德混悬液经鼻雾化治疗慢性鼻窦炎伴鼻息肉的疗效和安全性研究[J]. 临床耳鼻咽喉头颈外科杂志, 2012, 26(8): 347-350. WANG Chengshuo, LOU Hongfei, LOU Wei, et al. The efficacy and safety of a short course of budesonide inhalation suspension via transnasal nebulization in chronic rhinosinusitis with nasal polyps[J]. J Clin Otorhinolaryngol Head Neck Surg, 2012, 26(8): 347-350.

相关文章 15

[1]	宋晓宇, 张宇, 李成林, 宋西成. 加速康复外科理念在慢性鼻-鼻窦炎伴鼻息肉手术治疗中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 9-12.
[2]	张汝祥,田昊,马有祥. 鼻内镜鼻窦手术前筛窦颅底高度的CT评估价值[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 75-77.
[3]	王驰,刘星,孔磊,洪兴和,宁博. 鼻内镜下等离子射频消融术对合并鼻窦炎的小儿腺样体肥大患者疗效及鼻腔黏膜纤毛清除功能的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 78-81.
[4]	吴喜福, 孔维封, 王玮豪, 徐惠清, 戚敏, 杨钦泰. QoR-15在加速康复外科改善慢性鼻-鼻窦炎伴鼻息肉围手术期生活质量评估中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 5-8.
[5]	乔叔芬,杨飞轮,王臻妮,李学忠. YKL-40与慢性鼻-鼻窦炎组织重构的相关性探讨[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 95-99.
[6]	黄远,巴罗,李波,余文兴,杨芳丽,杜进涛. 慢性鼻窦炎鼻息肉中转录因子NKX2-1调控嗜酸性炎症反应的作用[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 17-23.
[7]	陈望兴,赵雪,刘岩,刘悦,金春顺. 鼻中隔偏曲及慢性鼻窦炎鼻息肉患者的精神心理状态调查[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 24-27.
[8]	黄凯丰. 糖皮质激素短疗程雾化吸入对嗜酸粒细胞性鼻窦炎伴鼻息肉患者鼻部症状及肾上腺皮质功能的影响[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 28-31.
[9]	李华斌, 赖玉婷. 慢性鼻-鼻窦炎的发病机制及诊疗进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 4-9.
[10]	张桂敏,林鹏. 慢性鼻-鼻窦炎的内在型:从基础到临床[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 14-17.
[11]	陈鸣,俞雪飞. 浅谈伴有变应性鼻炎的慢性鼻窦炎的治疗[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 18-22.
[12]	娄鸿飞,王成硕. 慢性鼻窦炎分型研究进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 10-13.
[13]	张炜,曾昱菡,余先崧. 慢性鼻窦炎手术前后ECP、EGF、IL-6的水平变化及临床意义[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 63-67.
[14]	于倩倩,关鸽,张念凯,李娜,温君凤,刘婷婷,连媛媛. 鼻腔嗅裂区呼吸道上皮腺瘤样错构瘤的CT影像表现[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 76-81.
[15]	李莹. 慢性鼻窦炎的辨证论治[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 27-30.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed