【摘要】：目的比較鼻內(nèi)鏡術(shù)后采用布地奈德鼻腔灌洗與鼻腔噴劑治療對(duì)慢性鼻-鼻竇炎(CRS)合并哮喘患者的影響。方法對(duì)符合條件的48例CRS合并哮喘患者隨機(jī)分為灌洗組和噴霧組(n=24),灌洗組鼻內(nèi)鏡手術(shù)(ESS)后采用0.5 mg布地奈德溶于250 ml生理鹽水鼻腔灌洗,噴霧組ESS后采用布地奈德噴霧劑噴鼻。隨訪1、3及6個(gè)月,比較兩組治療前后漢化版鼻腔鼻竇結(jié)局測(cè)試22條(SNOT-22)、Lund-Kennedy(LK)內(nèi)鏡評(píng)分、口服類固醇和吸入類固醇的使用量。結(jié)果不同時(shí)間SNOT-22和LK內(nèi)鏡評(píng)分差異有統(tǒng)計(jì)學(xué)意義(P=0.000),灌洗組與噴霧組的SNOT-22和LK內(nèi)鏡評(píng)分差異有統(tǒng)計(jì)學(xué)意義(P=0.004和0.009),與噴霧組比較,灌洗組的SNOT-22和LK內(nèi)鏡評(píng)分較低,相對(duì)效果較好。灌洗組與噴霧組的SNOT-22和LK內(nèi)鏡評(píng)分變化趨勢(shì)差異有統(tǒng)計(jì)學(xué)意義(P=0.000)。兩組間入組后治療6個(gè)月期間口服激素總量比較,差異有統(tǒng)計(jì)學(xué)意義(P=0.000);兩組治療前后6個(gè)月口服激素總量比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組間及組內(nèi)術(shù)前6個(gè)月及治療后6個(gè)月期間使用吸入激素量,差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 CRS伴哮喘患者ESS后,布地奈德鼻腔灌洗是一種有效的方法,可以改善生活質(zhì)量,防止復(fù)發(fā)和減少使用口服類固醇,效果優(yōu)于鼻腔噴劑。但灌洗后吸入激素量沒(méi)有減少。
[Abstract]:Objective to compare the effects of budesonide nasal lavage and nasal spray on chronic rhinosinusitis (CRS) patients with asthma after endoscopic surgery. Methods 48 patients with CRS complicated with asthma were randomly divided into two groups: the lavage group and the spray group. The lavage group was treated with 0.5 mg budesonide dissolved in 250ml normal saline nasal cavity after endoscopic (ESS) operation, and the spray group was treated with budesonide spray after ESS. Two groups were followed up for 1 ~ 3 and 6 months. The endoscopic score of Lund-Kennedy (LK), the dosage of oral steroids and inhaled steroids were compared between the two groups before and after treatment in Chinese version of nasal cavity and paranasal sinus outcome test (SNOT-22). Results there were significant differences in SNOT-22 and LK endoscopy scores at different time points (P0. 000), and there were significant differences in SNOT-22 and LK endoscopy scores between lavage group and spray group (P0. 004 and 0.009). Compared with spray group, SNOT-22 and LK endoscopy scores in lavage group were lower and the relative effect was better. There was significant difference in SNOT-22 and LK endoscopy score between lavage group and spray group (P0. 000). There was significant difference in total oral hormone between the two groups during 6 months after treatment (P0. 000), and the total oral hormone before and after treatment in the two groups was higher than that in the control group. The difference was statistically significant (P0.05); there was no significant difference in the amount of inhaled hormone between the two groups before 6 months and 6 months after treatment (P0.05). Conclusion budesonide nasal lavage is an effective method for improving the quality of life, preventing recurrence and reducing the use of oral steroids after ESS in patients with CRS and asthma, and the effect is better than nasal spray. However, the amount of inhaled hormones did not decrease after lavage.
【作者單位】： 湖南省婁底市中心醫(yī)院耳鼻咽喉頭頸外科;中南大學(xué)湘雅醫(yī)院耳鼻咽喉頭頸外科;
【分類號(hào)】：R765.9
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本文編號(hào)：2189066