| 田秋实,初腾,逄明杰.慢性鼻 -鼻窦炎伴鼻息肉病人鼻内镜手术围手术期处理对嗅功能的影响[J].安徽医药,2021,25(2):341-344. |
| 慢性鼻 -鼻窦炎伴鼻息肉病人鼻内镜手术围手术期处理对嗅功能的影响 |
| Effectofperioperativemanagementonolfactoryfunctioninpatientswithchronicrhinosinusitis and nasal polyps |
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| DOI：10.3969/j.issn.1009-6469.2021.02.031. |
| 中文关键词: 鼻疾病 鼻窦炎 鼻息肉 鼻内镜手术 嗅功能 布地奈德 围术期处理 |
| 英文关键词: Nose diseases Sinusitis Nasal polyps Endoscopic sinus surgery Olfactory function Budesonide Periopera |
| 基金项目:青岛市医疗卫生优秀人才培养项目( V市 DTR2017Y15) |
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| 中文摘要: |
| 目的研究慢性鼻 -鼻窦炎( chronic rhinosinusitis，CRS)伴鼻息肉病人鼻内镜手术( endoscopic sinus surgery，ESS)围手术期处理对嗅功能的影响。方法选取 2017年 1月至 2019年 2月青岛大学附属青岛市市立医院行 ESS治疗的 CRS伴有鼻息肉及嗅觉障碍病人 122例，采用随机数字表法分为四组， ESS围手术期给予不同方式处理， A组术后给予甲泼尼龙联合银杏叶提取物治疗( n = 31)； B组术后给予纳吸棉联合布地奈德混悬液填塞鼻腔治疗( n = 31)； C组术后给予甲泼尼龙治疗(n = 30)； D组术后给予布地奈德喷鼻剂喷鼻治疗( n = 30)。所有病人于术前、术后 1个月、术后 3个月行 T&T嗅觉检测。结果四组嗅觉评分术前［A组 4.2(3.8，4.6)分， B组 4.2(3.8，4.6)分， C组 4.0(3.6，4.4)分， D组 4.2(3.8，4.65)分］、术后 1个月［A组 3.6(3.2，4.0)分， B组 3.0(2.6，3.6)分， C组 3.5(3.2，4.0)分， D组 3.4(3.2，4.0)分］、术后 3个月［A组 3.2(2.8，3.6)分， B组 2.6(2.2，2.8)分， C组 3.2 |
| 英文摘要: |
| Objective To explore the effect of perioperative management of endoscopic sinus surgery (ESS) on olfactory function inpatients with chronic rhinosinusitis (CRS) and nasal polyps.Methods ESS was performed in 122 patients with CRS accompanied bynasal polyps and olfactory disturbance in Qingdao Municipal Hospital Affiliated to Qingdao University from January 2017 to February2019. The patients were randomly assigned into four groups and treated in different ways during perioperative period. Group A receivedmethylprednisolone combined with Ginkgo biloba extract after operation (n = 31). Group B received cotton aspiration combined with budesonide suspension for nasal packing after operation (n = 31). Group C received methylprednisolone after operation (n = 30). Group D received budesonide nasal spray after operation (n = 30). T&T olfactory test was performed in all patients before operation, 1 month after operation and 3 months after operation.Results There were significant differences in olfactory score before operation [group A:4.2(3.8,4.6),group B: 4.2(3.8,4.6),group C: 4.0(3.6,4.4),group D: 4.2(3.8,4.65)], 1 month after operation [group A: 3.6(3.2,4.0),group B:3.0(2.6,3.6),group C: 3.5(3.2,4.0),group D: 3.4(3.2,4.0)] and 3 months after operation [group A: 3.2(2.8,3.6),group B: 2.6(2.2,2.8),group C: 3.2(2.75,3.6),group D: 3.2(2.6,3.65)] in the four groups(P < 0.05).There were no significant differences in scores among groups A, C and D at 1 and 3 months after operation(P > 0.05). The scores of group B were lower than those of the other groups at 1 and 3 months after operation(P < 0.05). The improvement rate of group B was 83.9% at 3 months after operation, which was higher than that of the other three groups(P < 0.05).Conclusion ESS and glucocorticoid therapy can improve the olfactory function of CRS patients with nasal polyps. Postoperative cotton aspiration combined with budesonide suspension filling nasal cavity can most significantly improve olfactoryfunction. |
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