功能性鼻内窥镜术后慢性鼻-鼻窦炎伴鼻息肉患者短期糠酸莫米

不良。功能性内窥镜鼻窦术（FESS）术后鼻腔粘膜转规

分为3个阶段，即术腔清洁、干燥阶段，粘膜转规竞争阶

段和上皮化完成阶段；国内有研究认为鼻内镜术后粘膜

完全恢复一般需要4月；鼻腔冲洗及糖皮质激素的局部

应用有助于抗炎及鼻腔粘膜上皮化的完成［4］。糠酸莫

米松鼻喷雾剂应用于FESS术后取得了一定的疗效［5］，但

在鼻腔填塞拔出后的早期阶段，由于术腔粘膜水肿和渗

出，而且术后填塞物取出后会有不同程度的血性分泌物

渗出，堵塞鼻腔鼻窦口，以致传统的鼻喷激素难以有效

被黏膜吸收，影响治疗效果。目前国内已有FESS术后

应用糖皮质激素雾化吸入治疗的报道［6］，但将糠酸莫米Clinical observation of short-term Mometasone Furoate Nasal Spray combined with saline wash in patients with chronic sinusitis after functional endoscopic sinus surgery CHEN Weizhang,CHEN Kai,ZHANG Zhixiong

Meizhou People`s Hosspital,Meizhou514000,China

摘要：目的探讨功能性鼻内窥镜术后慢性鼻-鼻窦炎伴鼻息肉患者短期糠酸莫米松盐水盥洗的疗效。方法选择功能性鼻内窥镜术的慢性鼻-鼻窦炎伴鼻息肉患者86例，采用随机数字表法将其分为观察组和对照组，每组43例。观察组术后给予糠酸莫米松盐水盥洗，对照组术后给予生理盐水盥洗及糠酸莫米松鼻喷剂喷鼻。比较两组患者术前的V AS评分和Kennedy评分；比较两组患者术后3d和盥洗治疗后的LKES评分和SNOT22评分；分析两组患者的不良反应发生情况。结果两组患者术前V AS评分、Kennedy评分的比较，差异无统计学意义（P>0.05）。两组患者盥洗治疗后的LKES评分、SNOT评分均低于术后3d，差异有统计学意义（P<0.05）；观察组盥洗治疗后的LKES评分（5.07±0.82分）与SNOT评分（13.41±0.74分）低于对照组，差异有统计学意义（P<0.05）。观察组有1例患者术后出现鼻腔活动性出血，给予压迫止血处理后可止血。两组其余患者均未见明显不良反应发生，均可顺利完成本研究治疗方案。结论功能性鼻内窥镜术后慢性鼻-鼻窦炎伴鼻息肉患者短期糠酸莫米松盐水盥洗有助于鼻黏膜的恢复，更好缓解患者临床症状。

关键词：功能性鼻内窥镜术；慢性鼻-鼻窦炎伴鼻息肉；糠酸莫米松；盐水盥洗

Abstract:Objective To investigate the efficacy of short-term mometasone furoate nasal spray combined with saline lavage in patients with chronic sinusitis after functional nasal endoscopy.Methods Eighty-six patients with chronic sinusitis with functional nasal endoscopy were selected.They were randomly divided into observation group and control group,with43 cases in each group.After the operation,the control group was given a saline wash and mometasone furoate nasal spray,while the observation group was given a wash of mometasone furoate.The vas and Kennedy scores of the two groups were compared before operation.LKES and SNOT22scores of the two groups were compared3days after operation and after lavatory treatment.The adverse reactions of the two groups were analyzed.Results The difference of VAS score and Kennedy score between the two groups was not significant(P>0.05).The LKES score and SNOT score of the two groups were significantly lower than those of the three days after the operation(P<0.05).The LKES score and SNOT score of the observation group were lower than that of the control group(P P<0.05).In the observation group,there was1case of active bleeding in the nasal cavity after operation,which could be stopped after compression and hemostasis.The other patients in the two groups did not have any obvious adverse reactions.It could successfully complete the treatment plan.Conclusion Short-term washing with mometasone furoate in patients with chronic rhionosinusitis with nasai polyps after functional nasal endoscopy can help the recovery of nasal mucosa and better alleviate the clinical symptoms of patients.

Keywords:functional endoscopic sinus surgery;chronic rhionosinusitis with nasai polyps;mometasone furoate;salt water lavage

收稿日期：2020-05-11

作者简介：陈伟章，主治医师，E-mail:chenweizhuang@

分子影像学杂志,2020,43(2):349-351doi10.12122/j.issn.1674-4500.2020.02.36·

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