基于双侧前瞻性随机研究生物止血粉联合布地奈德浸润用于慢性鼻窦炎鼻内镜术后价值

doi:10.3969/j.issn.1006-6233.2024.04.031

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摘要 目的: 基于自身左右侧前瞻性随机对照评价生物止血粉联合布地奈德浸润用于慢性鼻窦炎鼻内镜术后价值。方法: 前瞻性纳入2021年4月至2023年5月我院收治的102例慢性鼻窦炎患者进行随机对照研究,鼻内镜术后,布地奈德可降解止血棉浸润随机分配填塞一侧鼻腔(对照侧),生物止血粉联合布地奈德可降解止血棉浸润填塞另一侧(联合侧)。比较两侧鼻出血情况、鼻部症状、改良内镜Lund-Kennedy评分、填塞材料降解评分、纤毛清除率、嗅觉功能、纤毛清除速度、安全性。结果: 联合侧术后第1天、术后第3天、术后第7天、术后第14天鼻出血评分低于对照侧,差异有统计学意义(P<0.05);联合侧术后14d、术后1个月鼻塞、流脓涕、流清涕、面部肿胀评分低于对照侧,差异有统计学意义(P<0.05);联合侧术后第3天、术后第7天、术后第14天改良内镜Lund-Kennedy评分低于对照侧,差异有统计学意义(P<0.05);联合侧术后第7天、术后第14天填塞材料降解评分分布优于对照侧,差异有统计学意义(P<0.05);联合侧术后第7天、术后第14天纤毛清除率、纤毛清除速度高于对照侧,嗅觉功能评分低于对照侧,差异有统计学意义(P<0.05);联合侧并发症与对照组侧无明显差异(P>0.05)。结论: 生物止血粉联合布地奈德浸润用于慢性鼻窦炎鼻内镜术后,不影响填塞材料降解,并能协同增强止血效果,改善鼻部症状、黏膜状态、嗅觉功能,提高纤毛功能,安全可靠。

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	胡志勇
	成美好

关键词 ：慢性鼻窦炎, 生物止血粉, 布地奈德, 鼻内镜术

Abstract：Objective: To evaluate the value of bioabsorbable hemostatic powder combined with budesonide soaking in postoperative endoscopic sinus surgery for chronic rhinosinusitis (CRS) based on a prospective randomized controlled study of the bilateral sides of the patients. Methods: A prospective randomized controlled study was conducted on 102 patients with CRS who were admitted to our hospital from April 2021 to May 2023. After endoscopic sinus surgery, budesonide absorbable hemostatic cotton soaked was randomly assigned to fill one side of the nasal cavity (control side), and bioabsorbable hemostatic powder combined with budesonide absorbable hemostatic cotton soaked was filled on the other side (combined side). The bleeding, nasal symptoms, modified endoscopic Lund-Kennedy score, filling material degradation score, ciliary clearance rate, olfactory function, ciliary clearance speed, and safety of the two sides were compared. Results: The bleeding scores on the combined side were lower than those on the control side on the 1st day, 3rd day, 7th day, and 14th day after surgery (P<0.05). The scores of nasal congestion, purulent rhinorrhea, clear rhinorrhea, and facial swelling on the combined side were lower than those on the control side on the 14th day and 1 month after surgery (P<0.05). The modified endoscopic Lund-Kennedy scores on the combined side were lower than those on the control side on the 3rd day, 7th day, and 14th day after surgery (P<0.05). The distribution of filling material degradation scores on the combined side was better than that on the control side on the 7th day and 14th day after surgery (P<0.05). The ciliary clearance rate and ciliary clearance speed on the combined side were higher than those on the control side on the 7th day and 14th day after surgery, and the olfactory function score was lower than that on the control side (P<0.05). There was no significant difference in complications between the combined side and the control side (P>0.05). Conclusion: Bioabsorbable hemostatic powder combined with budesonide soaking does not affect the degradation of filling materials after endoscopic sinus surgery for CRS, and it can synergistically enhance the hemostatic effect, improve nasal symptoms, mucosal status, and olfactory function, and improve ciliary function. It is safe and reliable.

Key words： Chronic sinusitis Biological hemostatic powder Budesonide Bilateral Nasal endoscopy

基金资助:福建医学科技青年培育项目,(编号:21FBQN2021047)

引用本文:

胡志勇, 成美好. 基于双侧前瞻性随机研究生物止血粉联合布地奈德浸润用于慢性鼻窦炎鼻内镜术后价值[J]. 河北医学, 2024, 30(4): 687-692.
HU Zhiyong, CHENG Meihao. Value of Bioabsorbable Hemostatic Powder Combined with Budesonide Soaking in Postoperative Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Prospective Randomized Bilateral Study. HeBei Med, 2024, 30(4): 687-692.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.04.031 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I4/687

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