Huang Zi-Zhen, Chen Xian-Zhen, Huang Jian-Cong, Wang Zhi-Yuan, Li Xia, Chen Xiao-Hong, Lai Xiao-Ping, Chang Li-Hong, Zhang Ge-Hua
Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, No. 600, Tianhe Road, Guangzhou, 510630, Guangdong, People's Republic of China.
Department of Otolaryngology-Head and Neck Surgery, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519020, Guangdong, People's Republic of China.
Eur Arch Otorhinolaryngol. 2019 May;276(5):1397-1403. doi: 10.1007/s00405-019-05327-6. Epub 2019 Feb 20.
Budesonide improves the prognosis of chronic rhinosinusitis (CRS). However, few reports have examined whether its use for nasal irrigation, compared to normal saline, improves the prognosis of patients after endoscopic sinus surgery (ESS). We compared the effects of nasal irrigation with budesonide and normal saline in CRS patients after ESS.
Sixty CRS patients who had undergone ESS were randomly divided into an experimental group (30 patients), which used budesonide nasal irrigation, and a control group (30 patients), which used normal saline nasal irrigation. All patients received regular follow-up evaluations and were assessed via questionnaires, including the Lund-Kennedy endoscopic score (LKES), the symptom visual analog scale (VAS), the 22-item Sino-Nasal Outcome Test (SNOT-22), the Short-Form 36-Item Questionnaire (SF-36), the Self-Rating Anxiety Scale (SAS), the Self-Rating Depression Scale (SDS) and a side effects scale.
Scores of polyposis, mucosal edema, secretions and total score of LKES; VAS scores of nasal blockage, hyposmia and rhinorrhea; and SNOT-22 results in both groups were significantly improved 3 months after ESS. Scores of polyposis, mucosal edema, secretions and scarring and total score of LKES in experimental group were significantly better than in control group 3 months after ESS. No significant differences were observed in SF-36, SAS or SDS before or 3 months after ESS within or between the two groups. The side effects of the two groups were not significantly different.
Nasal irrigation improved the prognosis of CRS patients after ESS. Budesonide nasal irrigation had a better effect than normal saline nasal irrigation.
布地奈德可改善慢性鼻-鼻窦炎(CRS)的预后。然而,与生理盐水相比,关于其用于鼻腔冲洗是否能改善内镜鼻窦手术(ESS)后患者预后的报道较少。我们比较了布地奈德鼻腔冲洗与生理盐水鼻腔冲洗对ESS后CRS患者的影响。
60例接受ESS的CRS患者被随机分为实验组(30例患者),使用布地奈德鼻腔冲洗,和对照组(30例患者),使用生理盐水鼻腔冲洗。所有患者均接受定期随访评估,并通过问卷进行评估,包括Lund-Kennedy内镜评分(LKES)、症状视觉模拟量表(VAS)、22项鼻-鼻窦结局测试(SNOT-22)、36项简短问卷(SF-36)、自评焦虑量表(SAS)、自评抑郁量表(SDS)和副作用量表。
ESS后3个月,两组的息肉样变、黏膜水肿、分泌物及LKES总分;鼻塞、嗅觉减退和流涕的VAS评分;以及SNOT-22结果均有显著改善。ESS后3个月,实验组的息肉样变、黏膜水肿、分泌物和瘢痕形成评分及LKES总分均显著优于对照组。两组内及两组间在ESS前或ESS后3个月的SF-36、SAS或SDS评分均无显著差异。两组的副作用无显著差异。
鼻腔冲洗改善了ESS后CRS患者的预后。布地奈德鼻腔冲洗比生理盐水鼻腔冲洗效果更好。