普米克令舒雾化的作用【老年慢性鼻-鼻窦炎患者术后普米克令舒鼻雾化吸入的疗效观察】

　　[摘要] 目的 探讨老年慢性鼻-鼻窦炎患者功能性鼻窦内镜手术（FESS）后应用普米克令舒鼻雾化吸入的疗效。 方法 60例老年慢性鼻-鼻窦炎患者，均行FESS治疗，随机分为两组，每组30例。治疗组术后第2天应用普米克令舒鼻雾化吸入治疗，每日1次，每次2 mL，由空气压缩雾化吸入机（PARI，德国百瑞公司）从鼻腔喷入，连续3周；对照组采用雷诺考特喷鼻，每日2次，每次2喷，两组其他的围术期常规治疗均相同。结果 根据视觉模拟量表（VAS）和Kennedy鼻内镜评分，治疗组和对照组总有效率分别是96.7%和80.0%，治疗组明显高于对照组（P ＜ 0.05）。 结论 普米克令舒配合PARI鼻雾化吸入机用于老年慢性鼻-鼻窦炎术后，安全性高，明显减轻黏膜的水肿，促进术腔上皮化，缩短术后恢复时间。
　　[关键词] 普米克令舒；慢性鼻-鼻窦炎；老年患者；功能性鼻窦内镜手术
　　[中图分类号] R765.41 [文献标识码] A [文章编号] 1673-7210（2012）08（b）-0064-02
　　Clinical observation on the therapeutic effect of nebulized Pulmicore Respules in elderly patients with chronic rhinosinusitis after functional endoscopic sinus surgery
　　ZHANG Mingxia ZHANG Qiuhang▲ WANG Zhenlin YAN Bo QI Yan
　　Department of Otolaryngology Head and Neck Surgery, Xuanwu Hospital Affiliated to Capital University of Medical Sciences, Beijing 100053, China
　　[Abstract] Objective To explore the clinical efficiency of nebulized Pulmicore Respules after functional endoscopic sinus surgery (FESS) in elderly patients with chronic rhinosinusitis. Methods 60 elderly patients with chronic rhinosinusitis after FESS were randomly divided into 2 groups, the one was treatment group, and the other was control group, each group had 30 cases. The patients in treatment group were treated with aerosol inhalation of Pulmicort Repulse, once a day, persisting for 3 weeks. The patients in control group were treated with Rhinocort nasal spray. The therapeutic effects were objectively assessed accoding to visual analogue scale (VAS) and subjectively assessed accoding to the Lund-Kennedy endoscopic scale. Results The total effective rate was respectively 96.7% in Pulmicore Respules treatment group and 80.0% in Rhinocort treatment group, so the effective rate of treatment group was significantly higher than that of control group, the difference was statistically significant (P ＜ 0.05). Conclusion Pulmicore Respules is a fine granule mixed liquid, with PARI SINUS nasal spray, it can significantly relieve the postoperative acute inflammation and oedema in elderly patients with chronic rhinosinusitis, and promote reepithelization and shorten the time of treatment.
　　[Key words] Pulmicore Respules; Chronic rhinosinusitis; Elderly patients; Functional endoscopic sinus surgery
　　随着我国老龄化社会的到来，老年慢性鼻-鼻窦炎患者日趋增多，据报道约17%的老年人（年龄≥60岁）患有慢性鼻窦炎、鼻息肉。近年来不断完善的鼻内镜技术已为老年慢性鼻-鼻窦炎患者的手术治疗提供了一个相对安全、有效的方法。由于慢性鼻-鼻窦炎发生和发展是多因素、多环节共同作用的结果，鼻内镜手术只是通过纠正鼻腔、鼻窦的解剖异常改善鼻腔、鼻窦的通气和引流，创造使鼻窦黏膜炎症转归的生理环境，加之老年人组织再生能力下降，术中还应尽量保留正常或稍肿胀肥厚而非息肉样变的黏膜，通过围术期药物治疗减轻术腔炎症水肿，促进术腔上皮化，缩短术后恢复时间[1]。因此，对慢性鼻-鼻窦炎的治疗，应以综合治疗为主，而综合治疗中的重要一环是糖皮质激素的应用[2]。本研究就老年慢性鼻-鼻窦炎患者功能性鼻窦内镜手术后应用普米克令舒鼻雾化吸入的疗效进行观察，现报道如下：