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特龙湾蜂蜜与类固醇浸渍鼻腔填塞在鼻内镜鼻窦手术后的对比:一项随机对照试验。

Tualang honey versus steroid impregnated nasal dressing following endoscopic sinus surgery: a randomized controlled trial.

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.

Department of Otorhinolaryngology, Hospital Raja Permaisuri Bainun, Jalan Raja Ashman Shah, Ipoh, Perak, Malaysia.

出版信息

J Complement Integr Med. 2020 Dec 21;18(2):433-438. doi: 10.1515/jcim-2020-0001.

Abstract

OBJECTIVES

Recurrence rate of nasal polyps is high following endoscopic sinus surgery. To improve the surgical outcome, steroid impregnated nasal dressing is used postoperatively We aimed to compare the effect of Tualang honey impregnated nasal dressing with steroid impregnated nasal dressing on wound healing and surgical outcomes in post endoscopic sinus surgery patients.

METHODS

A prospective, randomized, controlled trial was carried out at two tertiary hospitals. 32 patients diagnosed with chronic rhinosinusitis and had underwent endoscopic sinus surgery were enrolled. The study group received 2 mL of Tualang honey nasal dressing and the control group received nasal dressing with 2 mL of triamcinolone 20 mg/mL as positive control. A 2 cm nasal dressing was placed longitudinally into the middle meatuses of both nasal cavities. Postoperative healing assessments of edema, crusting, secretions, scarring and symptoms were performed at postoperative day 7, 14, 28 and at 3 months using Sinonasal Outcome Test 22 questionnaire and modified Lund-Kennedy scoring system.

RESULTS

There were no significant differences noted in the scores of Sinonasal Outcome Test 22 and modified Lund-Kennedy at Day 7, 14 and 28 (p>0.05) for both groups. At 3rd month, patients in the triamcinolone group had lesser symptoms and better endoscopic findings (p<0.05).

CONCLUSION

Tualang honey is not as effective as steroid in achieving good wound healing and surgical outcomes in post endoscopic sinus surgery patients. Thus, it is not suitable as a substitute for steroid to reduce symptoms and prevent recurrence of disease.

摘要

目的

鼻息肉经内镜鼻窦手术后复发率较高。为了提高手术效果,术后使用类固醇浸渍的鼻腔敷料。我们旨在比较桃胶浸渍鼻腔敷料与类固醇浸渍鼻腔敷料对内镜鼻窦手术后患者伤口愈合和手术结果的影响。

方法

在两家三级医院进行了一项前瞻性、随机、对照试验。共纳入 32 例诊断为慢性鼻-鼻窦炎并接受内镜鼻窦手术的患者。研究组接受 2ml 桃胶鼻腔敷料,对照组接受 2ml 曲安奈德 20mg/ml 作为阳性对照。将 2cm 长的鼻腔敷料纵向放置在双侧鼻腔的中鼻道内。术后第 7、14、28 天和 3 个月,采用鼻内镜鼻窦结局测试 22 问卷和改良 Lund-Kennedy 评分系统对水肿、结痂、分泌物、瘢痕和症状的术后愈合情况进行评估。

结果

两组患者在第 7、14 和 28 天的鼻内镜鼻窦结局测试 22 评分和改良 Lund-Kennedy 评分均无显著差异(p>0.05)。在第 3 个月时,曲安奈德组患者的症状较轻,内镜检查结果较好(p<0.05)。

结论

桃胶在实现内镜鼻窦手术后患者良好的伤口愈合和手术结果方面不如类固醇有效。因此,它不适合替代类固醇来减轻症状和预防疾病复发。

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