激素在鼻内镜手术治疗鼻息肉的临床作用分析

目的探讨多发性鼻息肉内镜手术前后应用激素对患者治疗效果的影响及其治疗结果分析。方法将320例患者随机分为四组:未用激素组(A)、术后鼻腔表面激素喷雾组(B)、术前口服泼尼松激素组(C)、术前口服泼尼松激素术后鼻腔表面激素喷雾组(D)。各组患者均在全麻插管下采用Messerklinger术式,完整切除鼻腔息肉,分析比较各组患者术后1周头痛、脓涕、鼻塞、嗅觉减退、鼻黏膜充血肿胀等情况变化;评估术后4周鼻腔干痂、分泌物、反应膜、黏膜水肿、囊泡形成、窦口阻塞情况;观察比较各治疗组鼻息肉术后复发状况,进一步总结激素对内镜鼻息肉手术治疗效果的影响。结果术后鼻腔表面激素喷雾能有效改善鼻息肉患者术后1周的临床症状,鼻塞和鼻黏膜充血肿胀的差异有统计学意义(P<0.05);术前口服泼尼松联合术后鼻腔表面激素喷雾能降低鼻息肉患者内镜手术治疗后的复发率,统计学差异有显著性意义(P<0.01)。结论口服泼尼松联合术后布地奈德鼻腔表面喷雾治疗,能有效提高鼻内镜术治疗慢性鼻-鼻窦炎伴鼻息肉(CRSw-NP)的效果,可以作为CRSw-NP有效治疗方法。

Clinical Effect of Hormone Treatment for Nasal Polyps in Endoscopic Sinus Surgery

Objective To investigate the multiple nasal polyps after endoscopic surgery of hormone therapy on patients and treatment effect analysis.Methods the 320 patients were randomly divided into four groups： no use of hormone group（A）,after the surface of steroid nasal spray group（B）,preoperative oral prednisone steroid group（C）,preoperative oral prednisone surface steroid hormone nasal spray group after surgery（D）.Patients in each group were used under general anesthesia and intubation messerklinger procedure,and complete removal of nasal polyps in patients between each group a week headache,purulent nasal discharge,nasal congestion,hyposmia,nasal congestion and swelling and other changes in circumstances;assessment after four weeks nasal dry scab,secretions,the reaction membrane,mucosal edema,vesicle formation,sinus obstruction;observe and compare the recurrence of nasal polyps treated groups state,and further concluded hormones on endoscopic surgical treatment of nasal polyps.Results The postoperative nasal steroid spray can effectively improve the surface of nasal polyps in patients with clinical symptoms after one week,stuffy nose and nasal congestion and swelling of the difference was statistically significant（P0.05）;surgery combined with oral prednisone,nasal surgery the surface of nasal polyps in patients with hormone spray can reduce endoscopic recurrence rate after surgical treatment,statistically significant difference（P0.01）.Conclusion Oral prednisone joint surface after budesonide nasal spray treatment can effectively improve the nasal endoscopy Chronic nasal-sinusitis with nasal polyps（CRSw-NP） effect,can be used as an effective treatment CRSw-NP.