摘要
目的分析总结糖皮质激素对鼻息肉患者手术后的治疗效果。方法将2009年8月-2011年12月我院拟接受鼻内镜手术的49例鼻息肉患者数字随机分为治疗组（26例）和对照组（23例）;对照组行鼻息肉切除术,治疗组在对照组基础上采用糖皮质激素联合治疗。观察两组患者的临床疗效、并发症发生情况,并对作用机制进行初步探讨。结果治疗组总有效率为96.15%,高于对照组（78.26%）,差异有统计学意义（χ2=14.342,P〈0.05）;随访1年后复查治疗组1例复发（3.85%）,对照组4例复发（17.39%）,治疗组复发率明显低于对照组（χ2=9.657,P〈0.05）。治疗组手术时间、术中出血量均明显少于对照组;脓涕、嗅觉减退、头痛、鼻塞等并发症发病率也显著低于对照组;Lund-Mackey、SNOT-20评分、VAS评分明显优于对照组（P〈0.05）。治疗组ECP浓度、EOS细胞计数均显著低于对照组,差异具有统计学意义（P〈0.05）。结论糖皮质激素可以提高鼻息肉患者手术疗效,降低并发症的发生率,改善患者术后的预后;其机制与抑制嗜酸性粒细胞有关。
Objective To investigate the prognostic effect of glucocorticoid on nasal polyps. Methods 49 patients suffering from nasal polyps hospitalized for endoscopic surgery from Aug 2009 to Dec 2011 were randomly divided into treatment group （n = 26 ） and control group （n = 23 ）. All the patients of the control group underwent nasal polypectomy, while those of the treatment group were treated with combination of glucocorticoid medication and nasal polypectomy. The clinical curative effect and complications of both groups were evaluated. Results The effective rate of the treatment group was 96.15% , which was higher than that of the control group （78.26%） , with a statistically significant difference （x2= 14. 342, P 〈 0. 05 ）. In the treatment group, the operation time, intraoperative bleeding volume were significantly less than those of the control group. The incidences of complications such as purulent nasal discharge, hyposmia, headache, stuffy nose were significantly lower than those of the control group （ P 〈 0.05 ） , while the scores of Lund-Mackey, SNOT-20 and VAS were significantly better than those of the control group （P 〈 0.05 ）. After treatment, the concentration of ECP, EOS cell counts of the treatment group was significantly lower than that of the control group, and the differences were statistically significant （ P 〈 0. 05 ）. Conclusions Glucocorticoids can improve the curative effect, reduce the incidence of complications, and improve the prognosis of patients with nasal polyps. The mechanism may be related to inhibition of eosinophil.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2014年第4期327-330,共4页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
