鼻内镜下可吸收鼻窦药物支架手术对慢性鼻窦炎伴鼻息肉患者鼻腔菌群及预后的影响

Effect of nasal endoscopic absorbable drug stent surgery on nasal microflora and prognosis in patients with chronic sinusitis with nasal polyps

摘要:

目的 分析鼻内镜下可吸收鼻窦药物支架手术对慢性鼻窦炎伴鼻息肉患者鼻腔菌群及预后的影响。方法 选择2018年11月－2021年3月于该院耳鼻喉科就诊的80例慢性鼻窦炎伴鼻息肉患者纳入研究，依据随机数表法随机分为实验组和对照组，每组40例，对照组患者行鼻内镜Messerklinger微创手术，实验组患者在鼻内镜Messerklinger微创手术结束前将可吸收鼻窦药物支架置入。比较两组患者住院时间、鼻黏膜恢复时间及鼻腔恢复通气时间，以及不同治疗方式对于鼻腔黏膜菌群的影响，依据术后3周全部患者的临床表现进行疗效对比。结果 实验组住院时间、鼻黏膜恢复时间及鼻腔恢复通气时间均明显少于对照组（P < 0.05）。实验组术后鼻腔内弯曲杆菌属、肠球菌属阳性率明显低于对照组（P < 0.05）；实验组术后鼻腔内假单胞菌属、嗜血杆菌属、葡萄球菌属与对照组比较，差异无统计学意义（P > 0.05）。实验组术后治疗效果明显优于对照组（P < 0.05）。结论 鼻内镜下可吸收鼻窦药物支架手术治疗慢性鼻窦炎伴鼻息肉，可以明显促进鼻黏膜上皮化，降低术后患者鼻腔内弯曲菌属、肠球菌属阳性率，治疗效果显著，值得临床推广应用。

Abstract:

Objective To study and analyze the effect of nasal endoscopic absorbable drug stent surgery on nasal microflora and prognosis in patients with chronic sinusitis with nasal polyps.Methods 80 patients with chronic sinusitis and nasal polyps from November 2018 to March 2021 were selected in this study. According to the random number table method, they were randomly divided into two groups, which were the experimental group and the control group. There were 40 people in each group. Patients in the control group were received nasal endoscopic Messerklinger minimally invasive surgery, while patients in the experimental group were received an absorbable sinus drug stent before the nasal endoscopic Messerklinger minimally invasive surgery. The hospitalization time, the recovery time of the nasal mucosa and the ventilation recovery time of the two groups of patients were compared, and the effects of different treatment methods on the nasal mucosa flora were compared. The curative effects were compared based on the clinical manifestations of all the patients after 3 weeks.Results The hospitalization time, the recovery time of the nasal mucosa, and the recovery time of the nasal cavity in the experimental group were significantly less than those in the control group (P < 0.05). The positive rates of Campylobacter and Enterococcus in the nasal cavity of the experimental group were significantly lower than those in the control group (P < 0.05); Pseudomonas, Haemophilus and Staphylococcus in the nasal cavity of the experimental group had no statistical significance compared with the control group after surgery (P > 0.05). The postoperative treatment effect of the experimental group was significantly better than that of the control group (P < 0.05).Conclusion The treatment of chronic sinusitis with nasal polyps with absorbable sinus drug stents under nasal endoscopy can significantly promote the epithelialization of the nasal mucosa and reduce the positive rate of Campylobacter and Enterococcus in the nasal cavity after surgery. The therapeutic effect is significant and it is worthy of clinical promotion application.