术后植入鼻窦药物支架对慢性鼻窦炎伴鼻息肉患者的临床疗效分析
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R765.4

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川北医学院附属医院课题基金(2022JC016)。


Clinical efficacy analysis of postoperative sinus drug stent implantation in patients with chronic rhinosinusitis and nasal polyps
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    摘要:

    目的 探讨慢性鼻窦炎伴鼻息肉(CRSwNP)患者功能性鼻内镜术后2周植入全降解鼻窦药物支架的临床疗效与安全性。方法 采集川北医学院附属医院耳鼻咽喉头颈外科50例确诊患者,将其随机分为术中植入组与术后植入组,每组各25例,均采用功能性鼻内镜全组鼻窦开放和鼻息肉切除手术治疗。术中植入组作为对照组,在术中同期随机选择一侧术腔筛窦植入全降解鼻窦药物支架。术后植入组作为实验组,在术后2周局麻下经鼻内镜鼻腔清理后随机选择一侧术腔筛窦植入鼻窦药物支架。术后随访3个月,分别于术前及术后2、4、8、12周进行鼻部症状视觉模拟评分量表(VAS)评分及鼻内镜检查Lund-Kennedy评分进行评估。结果 两组患者鼻部症状VAS评分中,鼻塞评分在术后4、8、12周差异均具有统计学意义(P均<0.05);流涕评分在术后2、8、12周差异均具有统计学意义(P均<0.05);嗅觉、头部闷胀感评分在术后4、8周差异均具有统计学意义(P均<0.05)。两组患者鼻内镜检查Lund-Kennedy评分中,息肉、水肿评分在术后8、12周差异均具有统计学意义(P均<0.05);鼻漏评分在术后2、8、12周差异均具有统计学意义(P均<0.05);结痂评分在术后4、8、12周差异均具有统计学意义(P均<0.05)。结论 CRSwNP患者在术后2周植入全降解鼻窦药物支架较术中同期植入临床疗效更佳,安全可靠。

    Abstract:

    Objective To investigate the clinical efficacy and safety of implanting fully degraded sinus drug stents in patients with chronic thinosinusitis and nasal polyps (CRSwNP) 2 weeks after functional endoscopic sinus surgery. Methods A total of 50 patients diagnosed in the Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of North Sichuan Medical College were were collected and randomly divided into 25 cases in the intraoperative implantation group and 25 cases in the postoperative implantation group. Patients in both groups underwent functional endoscopic sinus surgery for total sinus opening and nasal polypectomy. The intraoperative implantation group was taken as the control group. During the operation, a fully degradable sinus drug stent was randomly implanted in one side of the ethmoid sinus in the surgical cavity at the same time. The postoperative implantation group was taken as the experimental group. Two weeks after endoscopic sinus surgery, the nasal cavity was cleaned by nasal endoscopy under local anesthesia, and one side of the ethmoid sinus was randomly selected to implant a fully degraded sinus drug stent. The patients were followed up for 3 months after the operation. The Visual Analogue Scale (VAS) score for nasal symptoms and the Lund-Kennedy score of nasal endoscopy were evaluated before operation and at 2,4,8 and 12 weeks after operation. Results In the VAS score of nasal symptoms in the two groups, there were significant differences in the nasal congestion scores at 4,8 and 12 weeks after operation, P<0.05 and in runny nose score at 2,8 and 12 weeks after operation (P<0.05). There were significant differences in olfactory and head swelling scores at 4 and 8 weeks after operation (P<0.05). In the Lund-Kennedy score of nasal endoscopy, there were significant differences in polyps and edema scores between the two groups at 8 and 12 weeks after operation (P<0.05), and in rhinorrhea score at 2,8 and 12 weeks after operation (P<0.05). There were significant differences in scab score at 4,8 and 12 weeks after operation (P<0.05). Conclusion It is safe and reliable for patients with CRSwNP implanted with fully degraded sinus drug stents at 2 weeks after surgery, who have better clinical efficacy than that during surgery.

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冯燚源,李源泉,张雪,刘海,杨洪斌.术后植入鼻窦药物支架对慢性鼻窦炎伴鼻息肉患者的临床疗效分析[J].中国耳鼻咽喉颅底外科杂志,2025,31(6):89-94

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  • 收稿日期:2025-04-07
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  • 在线发布日期: 2026-01-16
  • 出版日期: 2025-12-30
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