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婴儿洗发水与生理盐水冲洗对鼻内镜鼻窦手术效果及生活质量的影响比较。

Comparison of effects of baby shampoo vs. saline irrigation on endoscopic sinus surgery outcomes and quality of life.

机构信息

Departments of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University, Balikesir/Turkey.

出版信息

Auris Nasus Larynx. 2021 Jun;48(3):408-414. doi: 10.1016/j.anl.2020.08.009. Epub 2020 Aug 26.

Abstract

OBJECTIVE

Nasal irrigation is an important step of functional endoscopic sinus surgery (FESS) postoperative care. This study was performed to compare the effects of diluted baby shampoo (BS) and normal saline solution (NSS) irrigation on patients' quality of life (QoL) and surgical outcomes after FESS.

METHODS

This study included 77 patients who underwent FESS to treat chronic rhinosinusitis with nasal polyps. Lund-Mackay score, Lund-Kennedy endoscopic score (LKES), synechia score and QoL (using the Sinonasal Outcome Test (SNOT-22)) were evaluated.

RESULTS

LKES was significantly better in the BS group (p=0.001), especially in terms of nasal discharge and crust formation (p=0.024 and p=0.030, respectively) at 1 month postoperatively. However, no significant difference was found at 3, 6 or 12 months postoperatively (p=0.833, p=0.263, and p=0.346, respectively). The reduction of SNOT-22 score (between preoperative assessment and 1 month postoperatively) was significantly better in the BS than in the NSS group (p=0.025). However, no statistically significant differences were found between groups at 3, 6, or 12 months postoperatively (p=0.312, p=0.280, and p=0.285, respectively). In the evaluation of SNOT-22 subdomains, changes in psychological, rhinological and extranasal rhinological subdomains were significantly better in the BS group at 1 month postoperatively (p=0.019, p=0.010 and p=0.002, respectively).

CONCLUSION

Compared to irrigation with NSS, BS usage following FESS led to reductions of crusting, nasal discharge and synechia formation; moreover, it was associated with improved SNOT-22 scores, especially in psychological, rhinological and extranasal rhinological subdomains.

摘要

目的

鼻腔冲洗是功能性内窥镜鼻窦手术(FESS)术后护理的重要步骤。本研究旨在比较稀释婴儿洗发水(BS)和生理盐水溶液(NSS)冲洗对 FESS 后患者生活质量(QoL)和手术结果的影响。

方法

本研究纳入了 77 例因慢性鼻-鼻窦炎伴鼻息肉而行 FESS 治疗的患者。评估 Lund-Mackay 评分、Lund-Kennedy 内镜评分(LKES)、黏连评分和生活质量(使用鼻-鼻窦炎结局测试 22 项量表[SNOT-22])。

结果

BS 组在术后 1 个月时 LKES 显著更好(p=0.001),尤其是在鼻腔分泌物和结痂形成方面(p=0.024 和 p=0.030)。然而,术后 3、6 和 12 个月时无显著差异(p=0.833、p=0.263 和 p=0.346)。BS 组 SNOT-22 评分(术前评估与术后 1 个月)的降低显著优于 NSS 组(p=0.025)。然而,术后 3、6 和 12 个月时两组间无统计学差异(p=0.312、p=0.280 和 p=0.285)。在 SNOT-22 子域的评估中,BS 组在术后 1 个月时心理、鼻科学和鼻外鼻科学子域的变化显著更好(p=0.019、p=0.010 和 p=0.002)。

结论

与 NSS 冲洗相比,FESS 后使用 BS 冲洗可减少结痂、鼻腔分泌物和黏连形成,且与 SNOT-22 评分的改善相关,尤其是在心理、鼻科学和鼻外鼻科学子域。

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