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目的探讨洗鼻剂、高渗盐水鼻腔冲洗对鼻窦炎患者鼻内镜术后疗效的影响及应用价值。方法随机选取2012年1月至2016年2月进行鼻内镜手术的鼻窦炎患者120例,手术后采用糖皮质激素抗感染的治疗方法,随机分为术后行鼻腔冲洗的高渗盐水组、洗鼻剂组和未行鼻腔冲洗的对照组,每组40例。依据视觉模拟评分法(VAS)在术后3周、8周、6个月对鼻部改善情况进行主观评价;对术后6个月的治疗效果进行评价;观察3组术后8周黏膜恢复;采用糖精试验评价3组术后8周、6个月鼻纤毛输送速率。统计学检验水准取α=0.05,行R×C表的χ2分割检验时,α’=0.0125。结果洗鼻剂组及高渗盐水组总有效率均高于对照组,差异有统计学意义(P均<0.017),洗鼻剂组与高渗盐水组比较无统计学差异(P>0.05)。高盐渗水组及洗鼻剂组术后症状轻于对照组,术后3周、8周、6个月VAS评分比较差异均有统计学意义(P<0.01,P<0.05)。术后8周,高渗盐水及洗鼻剂组鼻黏膜病变率低于对照组,差异有统计学意义(P均<0.017)。3组患者术后8周、6个月的鼻黏膜纤毛输送速率比较差异均有统计学意义(P均<0.01)。结论鼻窦炎患者术后用鼻腔冲洗的后续治疗方法可以明显改善患者的主观症状,提高术后鼻腔功能的恢复程度和治愈率。
Objective To investigate the effect and application value of nasal washing and hypertonic saline nasal irrigation on the curative effect after endoscopic sinus surgery in patients with sinusitis. Methods A total of 120 sinusitis patients undergoing endoscopic sinus surgery from January 2012 to February 2016 were selected randomly and were treated with glucocorticoid anti-infective therapy after surgery. The patients were randomly divided into nasal irrigating hypertonic saline group, Nasal group and non-nasal irrigation control group, 40 cases in each group. Subjective evaluation of nasal improvement was made according to visual analogue scale (VAS) at 3 weeks, 8 weeks and 6 months after operation. The therapeutic effect at 6 months after operation was evaluated. The mucosal recovery The saccharin test was used to evaluate the delivery rate of nasal cilia in the three groups after 8 weeks and 6 months. Statistics test level take α = 0.05, R × C table chi-square test, α ’= 0.0125. Results The total effective rates of nasal and hypertonic saline groups were significantly higher than those of the control group (P <0.017). There was no significant difference between the nasal dialysis group and the hypertonic saline group (P> 0.05) . The symptom of high salt water seepage group and nasal decongestion group were lighter than that of the control group. There was significant difference in VAS scores at 3 weeks, 8 weeks and 6 months after operation (P <0.01, P <0.05). After 8 weeks, the nasal mucosal lesion rate in hypertonic saline and nasal wash group was lower than that in the control group, the difference was statistically significant (P <0.017). The nasal mucosal ciliary rate was significantly different between the three groups at 8 weeks and 6 months postoperatively (all P <0.01). Conclusion The follow-up treatment of nasal irrigation after sinusitis patients can significantly improve the subjective symptoms of patients and improve postoperative recovery of nasal function and cure rate.