普米克令舒在功能性鼻内镜手术中的应用及疗效观察_医学论文.docVIP

普米克令舒在功能性鼻内镜手术中的应用及疗效观察_医学论文 普米克令舒在功能性鼻内镜手术中的应用及疗效观察_医学论文 【摘要】 探讨普米克令舒对功能性鼻内窥镜手术后术腔恢复的影响。方法：27例慢性鼻-鼻窦炎伴鼻息肉Ⅱ型Ⅲ期或Ⅲ型患者，采用双侧鼻腔自身对照，常规选取左侧鼻腔为普米克令舒治疗组，右侧鼻腔为对照组。手术结束前，用含普米克令舒混悬液的明胶海绵覆盖术腔。留置筛窦术腔膨胀海绵1周，术后每次换药予以含普米克令舒混悬液的明胶海绵覆盖筛窦术腔。记录患者术腔黏膜的转归过程。结果：普米克令舒治疗组术后2个月内各鼻窦分泌物逐渐减少，鼻腔黏膜肿胀反应轻，上皮化时间大大缩短，与对照组相比差异有统计学意义（P＜0.01）。治疗组92.6%的患者达到治愈的标准，疗效满意，与对照组85.2%的治愈率差异无统计学意义（P＞0.05）。结论：功能性鼻内窥镜术后局部使用普米克令舒能有效减轻术腔黏膜的炎症状态，加快术腔上皮化进程，促进黏膜的顺利转归，但对治愈率无明显影响。 【关键词】 鼻息肉 鼻窦炎 普米克令舒 内窥镜外科手术 ［ABSTRACT］ Objective: To investigate the effect of Pulmicort respule on rehabilitation of patients subjected to functional endoscopic sinus surgery(FESS). Methods: Twentyseven patients suffering from chronic rhinosinusitis of polyposis type Ⅱ stage Ⅲ or type Ⅲ were enrolled in this selfcontrolled study. The left nostril was subjected to Pulmicort respule using a swell sponge just before the end of the surgery, the right, however, was not. The swell sponges were kept in the nostril for 1 week, and absorbable gelatin sponges with Pulmicort respule were given into the same nostril each time when the patients came in the following stage. The transitionary process of the mucosa was determined. Results: The excretions were decreased, the mucosa intumescence was diminished, and epithelization was established in a shorter time in the experimental group than in the control group. The cure rate was 92.6% in the experimental group and 85.2% in the control group （P＞0.05）. There were no significant differences between the two groups. Conclusion: Using Pulmicort respule locally is a benefit for relieving mucosa inflammation, shortening the stage of epithelization, and accelerating the recovery of mucosa after FESS. ［KEY WORDS］ Nasal polyps Sinusitis Pulmicort respule Endoscopic surgical procedures, operative 随着鼻内镜外科技术的普及与发展，慢性鼻-鼻窦炎伴鼻息肉的治疗效果得到了明显提高。清除鼻腔鼻窦病变，恢复或改善鼻腔鼻窦的通气引流和正常功能是治疗慢性鼻-鼻窦炎鼻息肉的根本目的。值得重视的是，尽管功能性鼻内镜术后术腔护理及综合性治疗获得了越来越多的重视，但长达3个月甚至更长时间的术后随访换药给患者带来了心理和生理上的多重负担，在不发达地区患者较低的依从性直接影响了预后［1］。因此，缩短术后鼻腔鼻窦功能的恢复期，保证手术整体疗效是我们考虑的重点