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前瞻性随机双盲临床试验:鼻中隔成形术后早期使用丙酸氟替卡松进行大容量鼻腔冲洗。

A prospective randomized blinded clinical trial: large-volume nasal irrigation with fluticasone propionate in the early postoperative period following septoplasty.

机构信息

Department of Otorhinolaryngology, Faculty of Medicine, Bezmialem Vakif University, İstanbul, Turkey.

Department of Otorhinolaryngology, Bayrampaşa State Hospital, İstanbul, Turkey.

出版信息

Int Forum Allergy Rhinol. 2015 Jul;5(7):610-5. doi: 10.1002/alr.21527. Epub 2015 Apr 6.

DOI:10.1002/alr.21527
PMID:25845978
Abstract

BACKGROUND

The aim of this study was to compare 2 methods of nasal irrigation after septoplasty. The combined use of low-pressure, high-volume nasal saline (LPHVNS) irrigation, together with fluticasone propionate (FP) (LPHVNS+FP), was compared with high-pressure, low-volume nasal saline (HPLVNS) irrigation during the early postoperative period following septoplasty.

METHODS

Seventy-three patients undergoing septoplasty for nasal obstruction were recruited for the study. The patients were randomly divided into 2 groups; nasal irrigation was applied for 4 weeks in both groups. Group 1 (n = 40) used HPLVNS irrigation. Group 2 (n = 33) used the LPHVNS+FP combination. The patients were evaluated using the visual analogue scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE), nasal examination scores, acoustic rhinometry, rhinomanometry, and peak nasal inspiratory flowmetry (PNIF) measurements.

RESULTS

In group 2, the increase in VAS results was more prominent than in group 1. NOSE scores were significantly lower in group 2 than in group 1. The nasal examination revealed that group 2 had less edema and less crusting than group 1. The decrease in nasal airway resistance was significantly higher in group 2. The PNIF values increased to a significantly greater extent in group 2 than in group 1.

CONCLUSION

Nasal irrigation with the LPHVNS+FP combination during the early postoperative period following septoplasty is an effective method, resulting not only in increased patient satisfaction and nasal air flow but also in decreased edema and crust formation.

摘要

背景

本研究旨在比较鼻中隔成形术后两种鼻腔冲洗方法。在鼻中隔成形术后的早期,联合使用低压、大容量鼻腔盐水(LPHVNS)冲洗,并联合使用丙酸氟替卡松(FP)(LPHVNS+FP),与高压、小容量鼻腔盐水(HPLVNS)冲洗进行比较。

方法

招募了 73 名因鼻塞而行鼻中隔成形术的患者参加这项研究。患者被随机分为两组;两组均进行 4 周的鼻腔冲洗。第 1 组(n=40)使用 HPLVNS 冲洗。第 2 组(n=33)使用 LPHVNS+FP 联合治疗。使用视觉模拟量表(VAS)、鼻腔阻塞症状评估(NOSE)、鼻腔检查评分、声鼻反射测量法、鼻阻力测量法和最大鼻吸气流量测量法(PNIF)对患者进行评估。

结果

第 2 组的 VAS 评分增加更为显著。第 2 组的 NOSE 评分明显低于第 1 组。鼻腔检查显示第 2 组比第 1 组水肿和结痂少。鼻腔气道阻力下降程度在第 2 组明显更高。PNIF 值在第 2 组增加的幅度明显大于第 1 组。

结论

鼻中隔成形术后早期使用 LPHVNS+FP 联合鼻腔冲洗是一种有效的方法,不仅能提高患者满意度和鼻腔气流,还能减少水肿和结痂形成。

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