糖皮质激素对鼻息肉鼻内镜手术患者的疗效及术后生活质量的影响

摘要

Objective To explore the clinical effect and life quality of glucocorticoid on patients with nasal polyps after nasal endoscopic operation.Methods A total of 183 nasal polyps patients in Department of Otolaryngology of Zaoyang First People′s Hospital during May 2013 and May 2014,were randomly divided into the observation group of 95 cases and control group of 88 cases.The control group was treated with endo-scopic treatment,the observation groupwas treated with glucocorticoids based on the control group′s treat-ment, prednisone was administered orally on the mornings since the 7th day before operation,40 mg/d, which changed into 60 mg/d on the 2nd day before operation,and 5 mg/d on the 3rd day after operation, from the 4th day after operation to 6 month after operation,budesonide aerosol inhalation was given,2 times a day,1 spray each time,local spraying each dose 50 μg.The general situation,clinical effect after 6 months and the life quality of the patients of the two groups were observed.Results The bleeding volume,operation time,hospitalization time of the observation group were significantly lower than the control group [ ( 63 ± 7) mL vs (140 ±10) mL,(36 ±7) min vs (47 ±9) min,(6 ±2) d vs (10 ±2) d,P<0.01]; the total efficiency 6 months after the operation of the observation group was 94.7%( 90/95 ) , the relapse rate was 2.1%(2/95),of the control group was 75.0%(66/88) and 10.2%(9/88),the difference was statistically significant( P<0.01) .The Lund-Mackey,SNOT-20 score of the observation group were significantly higher than the control group(P<0.01).Conclusion Glucocorticoid combined with nasal endoscope can improve the curative effect of nasal polyps,improve the life quality of the patients,thus can be used as the preferred treatment for nasal polyps.%目的：探讨糖皮质激素对鼻息肉鼻内镜手术患者的疗效及术后生活质量的影响。方法将2013年5月至2014年5月枣阳市第一人民医院耳鼻喉咽科诊治的183例鼻息肉患者依据随机数字表法分为两组：对照组88例，采用鼻内镜治疗；观察组95例，在对照组基础上联合局部应用糖皮质激素，术前7 d清晨口服泼尼松，40 mg／d，术前2 d时改为口服60 mg／d，术后3 d口服5 mg／d，术后4 d至6个月应用布地奈德雾化剂，每日2次，每次1喷，局部喷涂剂量每次50μg。观察两组手术一般情况、术后6个月疗效及患者生活质量。结果观察组患者术中出血量、手术时间、住院时间均显著少于对照组[（63±7） mL 比（140±10） mL，（36±7） min 比（47±9） min，（6±2） d 比（10±2） d]，比较差异均有统计学意义（P＜0.01）；观察组患者术后6个月后总有效率为94.7％（90／95）、复发率为2.1％（2／95），对照组总有效率为75.0％（66／88），复发率为10.2％（9／88），两组比较差异有统计学意义（P＜0.01）。观察组Lund-Mackey、鼻腔鼻窦结局测量20条评分显著低于对照组（P＜0.01）。结论糖皮质激素联合鼻内镜治疗鼻息肉患者能提高疗效，改善患者生活质量，可作为鼻息肉患者的首选治疗方案。