作　　者： (苏娟）; (吉晓滨）; (谢景华）; (李鹏）;

机构地区： 广州市第一人民医院耳鼻咽喉科,510180

出　　处： 《临床医学》 2017年第7期28-31,共4页

摘　　要： 目的观察不同鼻腔冲洗液剂量对变应性真菌性鼻-鼻窦炎(AFRS)患者手术预后的影响。方法将90例AFRS鼻内镜术后患者随机分为Ⅰ、Ⅱ、Ⅲ三组,每组30例,分别行250、500、1 000 ml 3%高渗盐水冲洗鼻腔。术前及术后1、3、6个月采用Lund-Mackay鼻窦CT评分法、视觉模拟量表(VAS)评分、鼻腔鼻窦结局测量-20(SNOT-20)、Lund-Kenenedy鼻内镜评分法进行评分;并统计术腔清洁时间、术腔黏膜上皮化时间及术后6个月内需进行鼻内镜清理的次数。结果术后1个月,Ⅲ组的VAS评分优于Ⅰ组(P<0.05);术后3个月Ⅱ、Ⅲ两组均优于Ⅰ组,且Ⅲ组优于Ⅱ组(P<0.05)。术后1、3、6个月,Ⅲ组的SNOT-20总评分均优于Ⅰ组(P<0.05);6个月Ⅱ组优于Ⅰ组(P<0.05)。术后1个月,Ⅱ、Ⅲ两组的Lund-Kenenedy鼻内镜评分均优于Ⅰ组(P<0.05)。Ⅱ、Ⅲ组术腔清洁及上皮化时间均早于Ⅰ组(P<0.05)。术后6个月内所需鼻内镜检查次数Ⅲ组少于Ⅰ组(P<0.05)。结论鼻内镜术后大剂量的3%高渗盐水(1 000 ml)行鼻腔冲洗,能改善临床症状,促进术腔黏膜上皮化进程,从而缩短病程。 Objective To observe the effect on the postoperative patients with allergic fungal rhinosinusitis （AFRS）by different dose of nasal irrigation liquid. Methods Ninety postoperative patients with AFRS were randomly divided into the group Ⅰ , Ⅱ and Ⅲ, they were irrigated with 250,500, 1 000 ml 3% hypertonic saline, respectively. All the assessments were carried out at preoperative and postoperative 1, 3, 6 months, by Lund-Mackay sinus CT scores, visual analogue scale （ VAS）, sino-nasal outcome test-20（SNOT-20）, Lund-Kennedy endoscopic scores. Comprehensive evaluation based on the statistic of the nasal cavity cleaning time and the epithelization time and the number of endoscopic cleaning demand in the postoperative 6 months. Results Compared with the group Ⅰ , the VAS score in group Ill had a better results at postoper- ative 1 month（P 〈0. 05） ; better results were obtained both in the group Ⅱ and group m at postoperative 3 months, and the group Ⅲ was better than the group Ⅱ （ P 〈 0. 05 ）. The total scores of SNOT-20 questionnaire at postoperative 1,3 and 6 months in group Ⅲ were lower than the group Ⅰ （ P 〈 0. 05 ） ; at postoperative 6 months in the group Ⅱ were lower than the group Ⅰ （P 〈 0. 05）. Lurid-Kennedy endoscopic scores in the group Ⅱ and Ⅲ were better than the group I at postop- erative 1 month （P 〈 0. 05）. The nasal cavity cleaning time and the epithelization time in the group Ⅱ andⅢ were earlier than those in the group I （P 〈 0. 05）. The number of endoscopic cleaning in the group Ⅲ was less than that of the group Ⅰ demand in the postoperative 6 months （P 〈 0.05 ）. Conclusion Nasal endoscopic surgery may shorten the cavity cleaning time, promote the process of epithelization, so as to improve the clinical symptoms, shorten the course of disease by high dose such as 1 000 ml 3 % hypertonic saline for nasal irrigation.

关 键 词： 变应性真菌性鼻 鼻窦炎 鼻内镜手术 鼻腔冲洗 高渗盐水