Mohebbi Alireza, Hosseinzadeh Farideh, Mohebbi Saleh, Dehghani Ali
ENT and Head & Neck Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.
Skull Base Research Center, The Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2019 Dec 25;33:150. doi: 10.34171/mjiri.33.150. eCollection 2019.
Rhinosinusitis is an inflammatory disease of the nasal and paranasal sinus mucosa, and it becomes chronic when it lasts longer than 3 months without symptom improvement. The aim of this study was to determine the effect of PRP on improvement of endoscopic sinus surgery. This was a randomized clinical trial (RCT) designed and implemented on 21 patients with chronic rhinosinusitis in Rasool Akram hospital in Tehran during 2016-2017. In this study, one side of the nose was randomly selected as the control and the other side as the case, and at the end of the surgery, PRP was sprayed onto the surface where the polyp was removed in the side that was intended as the case. The nasal endoscopy findings were graded according to Meltzer's criteria before and after surgery and CT findings were classified according to the Lund-Mackay scoring system. Then, all patients were followed for 6 months. The SNOT-22 questionnaire, charts of Meltzer's criteria, and Lund-Mackay were used for data collection. Kolmogorov-Smirnov test, Wilcoxon Signed Rank test, and Mann-Whitney U test were used to analyze data in SPSS-22 software. P value<0.05 was considered significant. The mean and standard deviation of patients' age were 36.55 and 7.91, respectively. The median Lund-McKay Pre-op CT score before treatment was 10 (9.5-11), and no significant difference was found between the 2 sides of the nose (left and right). The items that showed statistically significant improvement after surgery was SNOT-22 (p<0.05). The mean of Meltzer scores in each side of the nose was significantly different before and after intervention (p<0.05). However, the mean of Meltzer scores in the 2 sides of the nose was not significantly different before and after intervention. The treatment by PRP may be effective in reducing symptoms of patients showing recurrence of CRS symptoms following endoscopic sinus surgery subjectively but not objectively.
鼻窦炎是鼻腔和鼻窦黏膜的炎症性疾病，当病程超过3个月且症状无改善时则变为慢性。本研究的目的是确定富血小板血浆（PRP）对改善鼻内镜鼻窦手术效果的作用。这是一项随机临床试验（RCT），于2016 - 2017年在德黑兰拉苏勒·阿克拉姆医院对21例慢性鼻窦炎患者进行设计和实施。在本研究中，随机选择一侧鼻腔作为对照，另一侧作为病例组，手术结束时，将PRP喷洒在病例组鼻腔内息肉切除部位的表面。术前和术后根据梅尔策标准对鼻内镜检查结果进行分级，CT检查结果根据伦德 - 麦凯评分系统进行分类。然后，对所有患者进行6个月的随访。使用SNOT - 22问卷、梅尔策标准图表和伦德 - 麦凯评分表收集数据。在SPSS - 22软件中使用柯尔莫哥洛夫 - 斯米尔诺夫检验、威尔科克森符号秩检验和曼 - 惠特尼U检验分析数据。P值<0.05被认为具有统计学意义。患者年龄的平均值和标准差分别为36.55和7.91。治疗前伦德 - 麦凯术前CT评分中位数为10（9.5 - 11），两侧鼻腔（左右）之间未发现显著差异。术后显示有统计学显著改善的项目是SNOT - 22（p<0.05）。干预前后两侧鼻腔梅尔策评分的平均值有显著差异（p<0.05）。然而，干预前后两侧鼻腔梅尔策评分的平均值无显著差异。PRP治疗可能在主观上而非客观上有效减轻鼻内镜鼻窦手术后出现慢性鼻 - 鼻窦炎（CRS）症状复发患者的症状。
