谢添慧　　熊向菁　　王青海　　李俊娟

[摘要] 目的 探讨鼻内镜手术联合糖皮质激素治疗慢性鼻窦炎患者的临床疗效。 方法 选择我院2018年5月至2020年5月收治的155例慢性鼻窦炎患者，随机分为观察组（n=78）和对照组（n=77）。对照组采用鼻内镜手术治疗，观察组在此基础上联合糖皮质激素治疗。观察比较两组临床疗效、Lund-Kennedy评分及并发症发生情况。 结果 观察组总有效率为92.31%，高于对照组的80.52%（P<0.05）。治疗后，观察组Lund-Kennedy评分由（6.61±2.02）分下降至（1.41±0.31）分，对照组Lund-Kennedy评分由（6.43±1.71）分下降至（2.69±0.71）分（P<0.05），且观察组Lund-Kennedy评分低于对照组[（1.41±0.31）分 vs （2.69±0.71）分]，差異有统计学意义（P<0.05）。观察组术后并发症总发生率（7.69%）低于对照组（19.48%），差异有统计学意义（P<0.05）。 结论 鼻内镜手术联合糖皮质激素治疗慢性鼻窦炎临床疗效显著，可有效缓解临床症状，降低Lund-Kennedy评分及并发症发生率，安全性高。

[关键词] 鼻内镜手术;糖皮质激素;慢性鼻窦炎;Lund-Kennedy评分;黏膜水肿

[中图分类号] R765.9          [文献标识码] B          [文章编号] 1673-9701（2021）09-0096-03

Analysis on the clinical efficacy of nasal endoscopic surgery combined with glucocorticoid in the treatment of patients with chronic sinusitis

XIE Tianhui  XIONG Xiangjing  WANG Qinghai   LI Junjuan

Department of Otolaryngology， Xi′ning No.1 People′s Hospital， Xi′ning   810000， China

[Abstract] Objective To investigate the clinical efficacy of nasal endoscopic surgery combined with glucocorticoid in the treatment of patients with chronic sinusitis. Methods A total of 155 patients with chronic sinusitis admitted to our hospital from May 2018 to May 2020 were selected， and they were randomly divided into the observation group（n=78） and the control group（n=77）. The control group was treated with nasal endoscopic surgery， while the observation group was treated with glucocorticoid on this basis. The clinical efficacy， Lund-Kennedy score and incidence of complications of the two groups were observed and compared. Results The total efficacy rate of the observation group was 92.31%， higher than 80.52% of the control group（P<0.05）. After treatment， the Lund-Kennedy score of the observation group decreased from （6.61±2.02） points to （1.41±0.31） points， while that of the control group decreased from （6.43±1.71） points to （2.69±0.71） points（P<0.05）， and Lund-Kennedy score of the observation group was lower than that of the control group（[1.41±0.31] points vs [2.69±0.71] points）， with statistically significant differences（P<0.05）. The total incidence of postoperative complications in the observation group was 7.69%， lower than 19.48% in the control group， with statistically significant difference（P<0.05）. Conclusion Nasal endoscopic surgery combined with glucocorticoids is effective in treating chronic sinusitis， which can effectively relieve clinical symptoms and reduce Lund-Kennedy score and incidence of complications， with high safety.

[Key words] Nasal endoscopic surgery; Glucocorticoid; Chronic sinusitis; Lund-Kennedy score; Mucosal edema

慢性鼻窦炎（Chronic sinusitis）是耳鼻喉科常见疾病，指鼻窦的慢性化脓性炎症，常为多个鼻窦同时受累;具有发病率高、病程长、易反复等特点，好发于低龄或年老体弱者[1]。慢性鼻窦炎的发生，多由急性鼻窦炎、阻塞性病因、牙源性感染及外伤异物等多因素所导致[2]。鼻内镜手术凭借疗效好、视野佳、伤口小等优点，在临床中被广泛应用于慢性鼻窦炎的治疗;可以对鼻窦引流通道进行有效疏通，去除病变组织，鼻窦开口扩大，生理功能恢复，症状缓解[3]。但是，单纯手术治疗不能根治炎症，术后并发症较多，存在较高的复发风险[4]。因此，探索科学有效的治疗方案，对抑制病情复发具有重要意义。近年来，糖皮质激素作为一种抗炎及免疫抑制剂，在慢性鼻窦炎的治疗中被逐渐重视应用，有效发挥抗炎及非特异性抑制免疫作用等[5]。本研究选择2018年5月至2020年5月我院收治的155例慢性鼻窦炎患者进行分析，旨在为此类患者的临床治疗提供科学理论依据，现报道如下。……