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内镜鼻窦手术后单次第七日清创与频繁清创的比较:一项随机对照试验

Single seventh day debridement compared to frequent debridement after endoscopic sinus surgery: a randomized controlled trial.

作者信息

Varsak Yasin Kursad, Yuca Koksal, Eryılmaz Mehmet Akif, Arbag Hamdi

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Meram Medical Faculty, Necmettin Erbakan University, 42080, Konya, Turkey.

Department of Otorhinolaryngology, Head and Neck Surgery, Selcuk University, Konya, Turkey.

出版信息

Eur Arch Otorhinolaryngol. 2016 Mar;273(3):689-95. doi: 10.1007/s00405-015-3630-9. Epub 2015 Apr 23.

Abstract

UNLABELLED

The aim of this study was to evaluate the postoperative debridement frequency following endoscopic sinus surgery. Individual randomized controlled trial. Sixty-two adult patients with a diagnosis of chronic rhino sinusitis (CRS) with nasal polyps (NP) and CRS without NP meeting the inclusion criteria were enrolled in this prospective study. The patients were randomized equally to frequent debridement (FD; at postoperative weeks 1, 2 and 4) or to a single debridement (SD; at postoperative week 1) after surgery. The outcomes were assessed with visual analog scale (VAS) for nine main symptoms concerning patient discomfort within the first 4 weeks, with the modified Lund-Kennedy endoscopic score (MLKES) at weeks 4 and 24 and with the sino-nasal outcome test-20 (SNOT-20) at week 24. Thirty-seven of the patients were male, and twenty-five were female. The mean age was 36.1 ± 13.5 in FD group and 39.2 ± 14.7 in SD group. In the SD group, the VAS scores at postoperative week four showed significantly less discomfort at visits (p = 0.004) and less negative effects on their work (p = 0.013). There was no statistically significant difference between the two groups in the week 4 and 24 MLKES and in the week 24 SNOT-20 scores (p > 0.05). The endoscopic findings did not show significant differences between the groups. Our data indicate that FD causes more discomfort at the required visits, more facial pain and more negative effects on patients' work; this method is not superior to postoperative single seventh day debridement in terms of the 24-week quality of life and endoscopic scores.

LEVEL OF EVIDENCE

1b.

摘要

未标注

本研究的目的是评估鼻内镜鼻窦手术后的术后清创频率。个体随机对照试验。62例诊断为伴有鼻息肉的慢性鼻-鼻窦炎(CRS)及不伴有鼻息肉的CRS且符合纳入标准的成年患者被纳入这项前瞻性研究。患者术后被随机均分为频繁清创组(FD;术后第1、2和4周)或单次清创组(SD;术后第1周)。通过视觉模拟量表(VAS)评估术后前4周内与患者不适相关的9种主要症状,在第4周和第24周采用改良的Lund-Kennedy内镜评分(MLKES),在第24周采用鼻窦结局测试-20(SNOT-20)进行评估。患者中37例为男性,25例为女性。FD组的平均年龄为36.1±13.5岁,SD组为39.2±14.7岁。在SD组,术后第4周的VAS评分显示就诊时不适明显减轻(p = 0.004),对工作的负面影响也较小(p = 0.013)。两组在第4周和第24周的MLKES以及第24周的SNOT-20评分方面无统计学显著差异(p>0.05)。内镜检查结果在两组之间未显示出显著差异。我们的数据表明,FD在所需就诊时会引起更多不适、更多面部疼痛以及对患者工作产生更多负面影响;就24周的生活质量和内镜评分而言,该方法并不优于术后第7天单次清创。

证据级别

1b。

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