袁野

【摘要】 目的：观察变应性真菌性鼻窦炎鼻内镜术后给予高渗盐水及抗生素进行鼻腔冲洗的效果。方法：选取2017年1月-2018年3月于笔者所在医院实施鼻内镜手术的变应性真菌性鼻窦炎患者160例。随机分为对照组和观察组，对照组给予高渗盐水冲洗鼻腔，观察组给予高渗盐水及抗生素冲洗鼻腔。观察两组不同时间Lund-Mackay鼻内镜CT评分、VAS评分、鼻腔纤毛传输速度及生活质量评分。结果：术后1、6、12个月，观察组Lund-Mackay鼻内镜CT评分和VAS评分均低于对照组（P<0.05）;术后6、12个月，觀察组鼻腔纤毛传输速度均高于对照组（P<0.05）;术后12个月，观察组生理问题、情感问题及功能限制评分均低于对照组（P<0.05）。结论：变应性真菌性鼻窦炎鼻内镜术后给予高渗盐水及抗生素进行鼻腔冲洗的效果确切，可改善临床症状，改善鼻腔纤毛功能和生活质量。

【关键词】 变应性真菌性鼻窦炎 鼻内镜 高渗盐水 抗生素 鼻腔冲洗

doi：10.14033/j.cnki.cfmr.2020.18.061 文献标识码 B 文章编号 1674-6805（2020）18-0-03

Effect of Nasal Irrigation with Hypertonic Saline Combined with Antibiotic after Nasal Endoscopic Surgery for Allergic Fungal Sinusitis/YUAN Ye. //Chinese and Foreign Medical Research， 2020， 18（18）： -144

[Abstract] Objective： To observe the effect of nasal irrigation with hypertonic saline combined with antibiotic after nasal endoscopic surgery for allergic fungal sinusitis. Method： A total of 160 patients with allergic fungal sinusitis who underwent nasal endoscopic surgery in our hospital from January 2017 to March 2018. They were randomly divided into the control group and the observation group. The control group was given hypertonic saline to rinse the nasal cavity. The observation group was given hypertonic saline combined with antibiotics to rinse the nasal cavity. Lund-Mackay endoscopic CT scores， VAS scores， nasal cilia transmission speed and quality of life scores at different times were observed between the two groups. Result： Lund-Mackay endoscopic CT scores and VAS scores in the observation group were lower than those of the control group at 1， 6 and 12 months after surgery （P<0.05）. At 6 and 12 months after surgery， the nasal cilia transmission speed of the observation group was higher than that of the control group （P<0.05）. At 12 months after surgery， the physiological problem， emotional problem and functional restriction scores of the observation group were lower than those of the control group （P<0.05）. Conclusion： Hypertonic saline combined with antibiotic for nasal irrigation after nasal endoscopic surgery for allergic fungal sinusitis has a clear effect， which can improve clinical symptoms， improve nasal cilia function and quality of life.

[Key words] Allergic fungal sinusitis Nasal endoscopy Hypertonic saline Antibiotics Nasal irrigation

First-authors address： Xianning Central Hospital， Xianning 437100， China

变应性真菌性鼻窦炎是一种特异性感染性疾病，是非侵袭性真菌性鼻窦炎[1]。鼻内镜手术是临床治疗变应性真菌性鼻窦炎的常用方法。变应性真菌性鼻窦炎患者采用鼻内镜手术后可在短期内获得良好的疗效，但术后易发生多种并发症，且术后复发率较高[2]。鼻内镜术后实施鼻腔冲洗可减少术腔瘀痂和分泌物，降低术后并发症发生率和复发率[3]。因此，鼻腔冲洗已被广泛应用于鼻内镜术后治疗中。但对于选择何种冲洗液实施术后鼻腔冲洗的问题，临床尚无统一标准。本文主要研究高渗盐水及抗生素进行鼻腔冲洗的效果。

1 资料与方法

1.1 一般资料

选取2017年1月-2018年3月于笔者所在医院实施鼻内镜手术的变应性真菌性鼻窦炎患者160例。纳入标准：（1）确诊为变应性真菌性鼻窦炎;（2）有鼻内镜手术适应证;（3）意识清楚。排除标准：（1）精神疾病;（2）严重内科基础疾病;（3）全身感染等疾病;（4）对本研究中药物过敏;（5）术前7 d使用过抗生素。……