张念武　费聿旭　陈祥雷　田文波　张永奇　袁　海

【摘要】 目的 鼻内镜术后应用自制中药液加西药液冲洗鼻腔，观察鼻腔黏膜变化，为鼻腔术后黏膜的早期修复，寻求中西医结合治疗的有效方法。方法 鼻内镜手术患者120例，随机分为两组，中西药结合组60例患者用生理盐水250 ml加庆大霉素8万U以及自制中药液250 ml，于术后第2天取出鼻腔油纱条开始每日冲洗鼻腔2次，对照组60例患者同法用生理盐水、甲硝唑各250 ml冲洗，予以记录。结果 两组术后第3天各项指标评分经t检验，差异无统计学意义(P>0．05)，于术后第5、7、9、11天各项指标评分中西药结合组均明显高于对照组(P<0．05)。结论 术后用中西药液结合冲洗鼻腔可以提高鼻内镜手术的疗效。

【关键词】 鼻窦炎；鼻息肉；术后冲洗；黏膜变化

Analysis of the recovery of nasal mucosa With post-operative washing

ZHANG Nian-wu，FEI Yu-xu，CHEN Xiang-lei，et al.

Department of otolaryngology，Ri zhao Hospital of Traditional Chinese medicine,Ri zhao 276800，China

【Abstract】 Objective To investigate the recovery of nasal mucosa by washing nasal cavity with self-made Chinese herbal solution and westen medicine solution after ESS.Methods 120 cases of nasosinusitis and rhinopolyps receiving ESS were divided randomly into two groups:group 1 washed with n-s(250 ml)and self-made Chinese herbal solution(250 ml)、80 000 U Gentamicin group2 with metronidazolum(250 ml)and n-s(250 ml).All cases received treatments on the second day after endoscopic surgery and were washed twice a day.The changes of inflammation of mucosa,disapearance of blood scab and desquamate of pseudomem brane as index were detected every two days.Results There were no significant difference in two groups thrnmmb detections on the 3th day(P>0．05)and have significant difference on the 5,7，9 and 11 day(P<0．05).Conclusion Chinese herbal and western medicine solution intra-cavity washing have more superiority in promoting the recovery of mucosa than the single western medicine.

【Key words】

Sinusitis；Nasal poly；Postoperative washing； Recovery of mucosa

本院自2002年1月至2004年1月,对慢性鼻窦炎鼻息肉患者,施行功能性鼻内镜手术后,采用自制中药液加抗生素冲洗鼻腔，并采用生理盐水与甲硝唑冲洗做对照,观察术后鼻腔鼻窦黏膜的恢复情况，现报告如下。

1 资料和方法

1．1 临床资料 2002年1月至2004年1月在本院经副鼻窦CT扫描确诊为鼻窦炎鼻息肉患者120例(223例),按照97年海口标准^[1]进行临床分型:I型I期15例,II期23例,III期13例;II型I期21例,II期83例,III期29例,III型39例。随机均分为两组,中西药冲洗结合组:男38例,女22例,年龄16~60岁,平均(36±8．2)岁,病程5个月~10年,平均3年。对照组:男36例,女24例,年龄15~58岁,平均(35．6±8．9)岁,病程6个月~9年,平均3．5年。两组资料比较差异无统计学意义(P>0．05)。

1．2 全部患者均接受内窥镜手术,手术采用Merssklinger式,手术切除钩突、筛泡，并根据情况开放各窦。

1．3 中药冲洗液制法 每付用黄芩12 g麻黄、6 g，辛夷9 g，苍耳子9 g，薄荷9 g，送中药房煎制，瓶装备用。