目的：探讨修正性鼻内镜手术联合克拉霉素治疗复发性慢性鼻‐鼻窦炎（RC RS ）的疗效。方法根据治疗方法的不同，将2009年12月至2015年6月诊治的62例RC RS患者分为单独修正性鼻内镜手术组（单独组）和修正性鼻内镜手术联合克拉霉素组（联合组），每组各31例。比较两组患者临床疗效及其他指标。结果治疗后两组患者鼻塞、流涕、头痛和嗅觉减退评分均显著改善（ P＜0．05），联合组鼻塞、流涕、头痛和嗅觉减退评分均明显低于单独组（ P＜0．05）。联合组治疗有效率为90．32％，明显高于单独组的64．52％（ P＜0．05）。疗程结束后，两组患者黏膜纤毛传输速率水平显著升高（ P＜0．05），联合组黏膜纤毛传输速率改善程度优于单独组（P＜0．05）。联合组术腔清洁时间和上皮化时间明显短于单独组（P＜0．05）。结论修正性鼻内镜手术后予以克拉霉素可显著提高RC RS临床疗效。%Objective To explore the effects of modified endoscopic sinus surgery combined clarithromycin in treatment of re‐fractory chronic rhinosinusitis(RCRS) .Methods Between December 2009 and June 2015 ,62 cases of RCRS patients were chosen and randomly divided into modified endoscopic sinus surgery group (single group) and modified endoscopic sinus surgery plus clar‐ithromycin group(combined group) ,with 31 cases in each group .Clinical efficacy and other indicators were compared between the two groups .Results After treatment ,the scores of olfactory dysfunction ,headache ,nasal congestion and runny nose in the two groups were significantly improved(P<0 .05) ,and the scores of olfactory dysfunction ,headache ,nasal congestion and runny nose of combined group were significantly lower than single group(P<0 .05) .The effective rate of combined group was 90 .32% ,higher than the 64 .52% of single group(P<0 .05) .At the end of the treatment ,the rate of mucosal cilia transmission was significantly higher than bofore in both groups(P<0 .05) ,and the improvement of combined group was significantly better than single group (P<0 .05 ) .The clean time and epithelial time of combined group were significantly shorter than single group ( P< 0 .05 ) . Conclusion Modified endoscopic sinus surgery combined with clarithromycin could significantly improve the clinical curative effect of patients with RCRS .
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