慢性鼻窦炎伴鼻息肉术后应用布地奈德的作用观察

目的探讨布地奈德对慢性鼻窦炎伴鼻息肉鼻内窥镜术后黏膜转归过程的干预作用。方法随机将174例Ⅱ型3期、Ⅲ型慢性鼻窦炎伴鼻息肉患者分成观察组（94例）及对照组（80例），先行鼻内窥镜鼻窦手术，观察组术后给予布地奈德喷鼻（128峭／每侧，每天一次），对照组为空白对照，分别对两组术后4周、12周鼻黏膜水肿情况、分泌物数量、窦口开放程度及术腔上皮化程度进行比较。结果术后4周达到临床治愈或临床好转（Ⅰ级）观察组44例（46．8％），对照组24例（30．0％）（P〈0．05）；术后4—12周完成延期治愈或迁延炎症（Ⅱ级）向Ⅰ级转变观察组45例（90．0％），对照组32例（57．1％）（P〈0．01）；术后12周总体达到Ⅰ级观察组89例（94．7％），对照组56例（70．0％）（P〈0．01）。结论对慢性鼻窦炎伴鼻息肉行鼻内窥镜鼻窦手术是可行的，布地奈德术后持续应用能明显减轻鼻腔黏膜水肿，减少术腔粘连，加快上皮化进程，防止息肉复发。

Clinical observation on Budesonide treatment for postoperative chronic rhinosinusitis with nasal polyps

Objective To explore the interfering effect of mucosal evolution on the budesonide treatment for chronic rhinosinusitis with nasal polyps after endoscopic surgery (ESS). Methods 174 cases of type Ⅱ stage 3 and type Ⅲ chronic rhinosinusitis with nasal polyps were randomly divided into experimental group (94 cases) and control group(80 cases). After ESS, budesonide was given to the experimental group (128 μg each side per day), but not to the control group. The comparison of mucosal edema, nasal pus accumulation, sinus meatal window, and epithelia of operation cavity were carried out respectively between two groups. Results 4 weeks later, class Ⅰ in experimental group was 46.8% (44/94), in control group was 30.0% (24/80) (P<0.05); 4 to 12 weeks later, the transfor-marion from class Ⅱ to Ⅰ in experimental group was 90.0% (45/50), in control group was 57.1% (32/56) (P<0.01); 12 weeks later, the total class Ⅰ in experimental group was 94.7% (89/94), in control group was 70.0% (56/80) (P < 0.01). The difference between 2 groups was of statistical significance. Conclusion Emphasizing the importance of integrated treatment after operation, ESS for the patients of sinusitis with nasal polyps was feasible, meanwhile, continuous use budesonide could alleviate mucosal edema, lessen conglutination, accelerate epithelia, and prevent recurrence of nasal polyps.