鼻窦药物缓释支架在难治性鼻窦炎中的短期临床观察

doi:10.6040/j.issn.1673-3770.0.2023.375

摘要/Abstract

摘要： 目的探讨功能性鼻内窥镜术中植入鼻窦药物缓释支架治疗难治性鼻窦炎的短期临床疗效。方法选取难治性鼻窦炎患者60例,依据随机数字表法将患者分为观察组和对照组。两组患者均行功能性鼻内窥镜手术,观察组在术中植入鼻窦药物缓释支架治疗,对照组术后给予常规围手术期药物治疗。术后4周,所有患者进行鼻腔鼻窦结局测试(sino-nasal outcome test-20, SNOT-20)评分进行主观症状评估,行鼻内镜检查及鼻窦CT,以鼻窦Lund-Kennedy及CT Lund-Mackay 评分进行客观评估鼻腔黏膜的恢复情况。最后观察两组的短期临床疗效、并发症及术后复发的情况。结果术后4周观察组临床疗效总有效率(93.33%)高于对照组(86.67%),而SNOT-20评分观察组较对照组低(P=0.02);观察组Lund-kennedy及Lund-Mackay评分较低(P=0.04,0.03);两组复发率没有统计学意义(P=0.27)。结论功能性鼻内窥镜术中植入鼻窦药物缓释支架治疗难治性鼻窦炎短期效果显著,能有效改善鼻黏膜形态,提高生活质量,且并发症少。

关键词: 鼻窦药物缓释支架, 难治性鼻窦炎, 功能性鼻内窥镜手术, 鼻窦黏膜, 并发症

Abstract: Objective To explore the short-term clinical effect of drug sustained-release stent implantation in functional endoscopic sinus surgery for refractory sinusitis. Methods Sixty patients with refractory sinusitis were randomized observation group and control group. Both groups of patients underwent functional endoscopic sinus surgery. The observation group received sinus drug sustained-release stent during surgery, while the control group received routine medication after surgery. Four weeks after surgery, all patients underwent the sino-nasal outcome test-20(SNOT-20)for subjective symptom scoring, and nasal endoscopy and CT scan were performed for objective evaluation of mucosal recovery based on the Lund-Kennedy and CT Lund-Mackay scores of the sinuses. The clinical efficacy, incidence of complications, and recurrence of the two groups were compared. Results Four weeks after surgery, the total clinical efficacy in the observation group(93.33%)was significantly higher than that of the control group(86.67%), while the SNOT-20 score in the observation group was lower(P=0.02). The Lund-Kennedy and Lund-Mackay scores in the observation group were lower(P=0.04,0.03); the recurrence rate was not statistically different between the two groups(P=0.27). Conclusion Implantation of drug sustained-release stent in the nasal sinus in functional endoscopic sinus surgery has a significant effect in the short-term for the treatment of refractory sinusitis, which can effectively improve the morphology of nasal mucosa, improve the quality of life, and result in fewer complications.

Key words: Drug sustained release stent implantation, Refractory sinusitis, Functional endoscopic sinus surgery, Sinus mucosa, Complications

中图分类号:

R765.4

李浩,杨丽媛,张守凯. 鼻窦药物缓释支架在难治性鼻窦炎中的短期临床观察[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 38-42.

LI Hao, YANG Liyuan, ZHANG Shoukai. Short-term clinical observation of drugsustained-release stent implantation in patients with refractory sinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2024, 38(3): 38-42.

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