加強藥物療法聯合鼻內鏡手術治療慢性鼻-鼻竇炎效果

練鍵勤　凌威 趙以謙

【摘要】 目的：研究加強藥物療法和鼻內鏡手術用于慢性鼻-鼻竇炎中的價值。方法：選取2017年9月-2019年9月筆者所在醫院接診的慢性鼻-鼻竇炎患者78例，利用奇偶數字分組法均分為兩組。試驗組聯用加強藥物療法和鼻內鏡手術，對照組僅行加強藥物治療。對比兩組炎癥因子、VAS評分、不良反應發生情況及治療效果。結果：治療前兩組癥狀VAS評分比較差異無統計學意義（P>0.05），治療后試驗組評分低于對照組，差異有統計學意義（P<0.05）。治療前兩組TNF-α、IL-8水平比較差異無統計學意義（P>0.05），治療后試驗組TNF-α、IL-8水平均低于對照組，差異均有統計學意義（P<0.05）。試驗組治療總有效率為97.44%，高于對照組的82.05%，差異有統計學意義（P<0.05）。試驗組不良反應發生率為0，低于對照組的12.82%，差異有統計學意義（P<0.05）。結論：加強藥物治療期間，采取鼻內鏡手術對慢性鼻-鼻竇炎患者進行佐治，可取得顯著療效，且利于其炎癥因子的有效控制，臨床癥狀的快速緩解，及不良反應的預防，建議推廣。

【關鍵詞】 加強藥物療法 鼻內鏡手術 慢性鼻-鼻竇炎 臨床療效

doi：10.14033/j.cnki.cfmr.2020.16.002 文獻標識碼 A 文章編號 1674-6805（2020）16-000-04

The Efficacy of Intensive Drug Therapy Combined with Endoscopic Sinus Surgery for Chronic Rhinosinusitis/LIAN Jianqin， LING Wei， ZHAO Yiqian. //Chinese and Foreign Medical Research， 2020， 18（16）： -6

[Abstract] Objective： To study the value of intensive drug therapy and nasal endoscopic surgery in chronic rhinosinusitis. Method： From September 2017 to September 2019， 78 patients with chronic rhino-sinusitis admitted to our hospital were selected， and they were evenly divided into two groups by the parity number grouping method. The experimental group was treated with intensive drug therapy and nasal endoscopic surgery， while the control group was only treated with intensive drug therapy. The inflammatory factors， VAS scores， adverse reactions and therapeutic effects were compared between the two groups. Result： There was no statistically significant difference in VAS scores between the two groups before treatment （P>0.05）， while the scores in the experimental group were lower than those in the control group after treatment， the difference was statistically significant （P<0.05）. There was no statistically significant difference in TNF-α and IL-8 levels between the two groups before treatment （P>0.05）， and both TNF-α and IL-8 levels in the experimental group were lower than those in the control group after treatment， the differences were statistically significant （P<0.05）. The total therapeutic effect rate in the experimental grooup was 97.44%， higher than 82.05% in the control group， the difference was statistically significant （P<0.05）. The incidence of adverse reactions in the experimental group was 0， which was lower than 12.82% in the control group， the difference was statistically significant （P<0.05）. Conclusion： During the enhancement of drug therapy， endoscopic surgery for the treatment of patients with chronic rhinosinusitis can achieve a significant effect， which is conducive to the effective control of its inflammatory factors， the rapid relief of clinical symptoms， and the prevention of adverse reactions. Therefore， it is recommended to promote the use of endoscopic surgery.

[Key words] Intensive drug therapy Endoscopic sinus surgery Chronic rhinosinusitis Clinical efficacy

First-authors address： Hui Ya Hospital of The First Affiliated Hospital， Sun Yat-sen University， Huizhou 516000， China

在耳鼻喉科疾病當中，慢性鼻-鼻竇炎十分常見，據有關調查數據顯示，成年人罹患慢性鼻-鼻竇炎的概率在1%～2%[1]。本病以嗅覺障礙、鼻塞、頭痛和流膿涕等為主癥，能夠對患者的身心健康造成損害，若治療不及時，將會引起肺部疾病，如支氣管哮喘和慢性支氣管炎等[2]。故早期的正確治療對于改善慢性鼻-鼻竇炎患者的預后來說至關重要。目前，臨床醫師可采取鼻內鏡手術或者是加強藥物療法來對慢性鼻-鼻竇炎患者進行治療，前者的目的在于徹底清除患者鼻竇口部位的復合體病變，以確保竇腔通氣的順暢[3]，后者為保守療法，雖能促進患者相關癥狀的緩解，但整體療效欠佳，且容易引起諸多的不良反應，比如面部不適和鼻漏等，不僅增加了患者的痛苦，同時還對其療效造成了不利影響[4]。此研……