鼻内镜手术联合药物治疗变应性真菌性鼻-鼻窦炎疗效分析

目的观察鼻内镜手术联合药物治疗变应性真菌性鼻-鼻窦炎的临床疗效。方法将68例变应性真菌性鼻-鼻窦炎患者分为3组,A组鼻内镜术后采用二性霉素B冲洗,每周2次,连续3个月;B组术前1周开始口服强的松40 mg/d,每周递减10 mg,连服4周,术后1周开始丙酸氟替卡松鼻腔喷用,连续使用3个月;C组在B组治疗方法基础上,于术后第1、5、9周口服伊曲康唑3个疗程,0.2 g/d,连服7 d为1疗程。分别于治疗前与治疗后12个月采用视觉模拟评分评估各组患者的临床症状,鼻内镜检查各组患者的鼻腔情况。统计3组临床疗效并记录药物的不良反应。结果在症状评估、鼻内镜评分、有效率3方面,C组优于B组,B组优于A组,所有患者未见明显药物不良反应。结论鼻内镜手术联合药物治疗变应性真菌性鼻-鼻窦炎疗效好,用药安全性高。

Efficacy analysis of functional endoscopic surgery combined with itraconazole and glucocrticosteroid for treating allergic fungal rhinosinusitis

Objective To observe the curative effect of functional endoscopic surgery combined with itraconazole and glucocrticosteroid for treating allergic fungal rhinosinusitis（ AFRS）. Methods 68 cases of AFRS were divided into 3 groups. All patients received functional endoscopic surgery. After operation,the patients of group A were treated by nasal douche with amphotericin B,twice a week for 3 consecutive months. The patients of group B began to take oral prednisone a week before operation,40 mg per day and 10 mg weekly decline,lasting for 4 weeks. Fluticasone propionate was started at 1 week after operation and lasted for three months. The patients of group C took oral itraconazole on the 1st,5th and 9th week after surgery based on the treatment of group B,0.2 g per day,for 7 d. The visual analog scale and nasal endoscopy were used for assessment of symptoms and recovery of nasal cavity before treatment and 12 months after treatment. Therapeutic effect and drug adverse reaction of the three groups were recorded and evaluated. Results of evaluation of symptoms,nasal endoscopic score and efficiency of the 3 groups showed better results in group C than those in group B; better results in group B than those in group A. No obvious drug adverse reactions were observed in all the patients. Conclusion Functional endoscopic surgery combined with itraconazole,glucocrticosteroid has advantages of good curative effect and drug safety in treatment of AFRS.