鼻腔冲洗与健康教育对水泥厂工人慢性鼻窦炎的协同影响：一项随机对照试验
Synergistic Impact of Nasal Irrigation and Health Education in Reducing Chronic Rhinosinusitis Among Cement Plant Workers: a Randomized Controlled Trial.
作者信息
Hung Nguyen Quang, Long Vo Hoang, Truong Nguyen Quang
机构信息
Department of Ear, Nose and Throat, Viet-Tiep Friendship Hospital, Haiphong. Vietnam.
University of Medicine and Pharmacy, Vietnam National University, Hanoi. Vietnam.
出版信息
Med Arch. 2025;79(3):184-189. doi: 10.5455/medarh.2025.79.184-189.
BACKGROUND
Chronic rhinosinusitis (CRS) is a prevalent and debilitating condition among industrial workers exposed to occupational hazards such as dust and chemical irritants. Despite its significant impact on quality of life and productivity, evidence-based interventions for occupational CRS remain limited.
OBJECTIVE
This study evaluates the effectiveness of combined health education and nasal irrigation in reducing CRS symptoms among direct labor workers at the Hai Phong Cement Plant, Vietnam.
METHODS
A randomized controlled trial was conducted from 2014 to 2015, involving 90 workers diagnosed with CRS. Participants were randomly assigned to an intervention group (n=45), receiving nasal irrigation kits and training, or a control group (n=45), receiving health education only. Health education sessions focused on improving knowledge, attitudes, and practices (KAP) related to CRS prevention. Nasal irrigation involved twice-daily rinsing with 0.9% saline solution. Outcomes were assessed using structured questionnaires, clinical examinations, and the Intervention Effectiveness Index (HQCT).
RESULTS
The health education intervention significantly improved KAP scores, with a 2967% increase in positive attitudes and an 847% improvement in understanding preventive measures. Nasal irrigation demonstrated substantial efficacy, reducing moderate nasal discharge by 58% and nasal congestion by 1600%. Objective findings revealed a 1657% increase in workers reporting no nasal cavity discharge and a 158% improvement in nasal mucosal health. After six months, 60% of the nasal irrigation group reported "good" improvement, compared to 11.1% in the control group (p < 0.05).
CONCLUSIONS
This study highlights the synergistic potential of health education and nasal irrigation in managing occupational CRS. Nasal irrigation, in particular, emerged as a highly effective, low-cost intervention for alleviating CRS symptoms in high-risk industrial settings. These findings underscore the importance of integrating non-pharmacological approaches into occupational health programs to safeguard respiratory health among workers exposed to environmental hazards.
背景
慢性鼻-鼻窦炎（CRS）在接触粉尘和化学刺激物等职业危害的产业工人中是一种普遍且使人衰弱的疾病。尽管其对生活质量和生产力有重大影响，但针对职业性CRS的循证干预措施仍然有限。
目的
本研究评估健康教育与鼻腔冲洗相结合在减轻越南海防水泥厂一线工人CRS症状方面的有效性。
方法
于2014年至2015年进行了一项随机对照试验，纳入90名被诊断为CRS的工人。参与者被随机分配到干预组（n = 45），接受鼻腔冲洗套件和培训，或对照组（n = 45），仅接受健康教育。健康教育课程侧重于提高与CRS预防相关的知识、态度和行为（KAP）。鼻腔冲洗包括每天用0.9%盐水溶液冲洗两次。使用结构化问卷、临床检查和干预效果指数（HQCT）评估结果。
结果
健康教育干预显著提高了KAP分数，积极态度提高了2967%，对预防措施的理解提高了847%。鼻腔冲洗显示出显著疗效，中度鼻分泌物减少了58%，鼻塞减少了1600%。客观结果显示，报告无鼻腔分泌物的工人增加了1657%，鼻黏膜健康改善了158%。六个月后，鼻腔冲洗组60%的人报告有“良好”改善，而对照组为11.1%（p < 0.05）。
结论
本研究强调了健康教育与鼻腔冲洗在管理职业性CRS方面的协同潜力。特别是，鼻腔冲洗成为在高风险工业环境中减轻CRS症状的一种高效、低成本干预措施。这些发现强调了将非药物方法纳入职业健康计划以保护接触环境危害的工人呼吸健康的重要性。
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