鼻窦药物洗脱支架治疗慢性鼻窦炎伴鼻息肉的疗效：一项多维研究

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中文摘要

目的： 比较术中中鼻道药物洗脱支架植入与单纯功能性内镜鼻窦手术（FESS）在慢性鼻窦炎主观症状、黏膜形态及炎症因子方面的疗效。
方法： 选取60例慢性鼻窦炎伴鼻息肉患者（长沙市中心医院，2023年1月至2024年6月），根据自愿治疗偏好分为两组：实验组术中植入支架，对照组行单纯FESS。术前及术后3个月、12个月评估鼻腔鼻窦结局测试22（SNOT-22）、Lund-Kennedy评分及鼻分泌物基质金属蛋白酶-9（MMP-9）。数据采用SPSS 27.0分析（p < 0.05为差异有统计学意义）。
结果： 两组术后所有指标均下降（p < 0.05）。3个月时MMP-9降低幅度相似（p > 0.05）；12个月时，实验组MMP-9降低幅度更大，相关症状评分下降更显著（p < 0.05）。
结论： 与单纯FESS相比，术中中鼻道药物洗脱支架植入可能在12个月随访期内对改善主观症状、加速鼻黏膜修复及抑制炎症提供额外获益。

英文摘要

OBJECTIVE: To compare the efficacy of intra-operative middle meatus drug-eluting stent implantation versus standalone functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis in subjective symptoms, mucosal morphology and inflammatory factors.
METHODS: Sixty chronic rhinosinusitis with nasal polyps patients (Changsha Central Hospital, January 2023 to June 2024) were assigned to two groups based on voluntary treatment preference: an experimental group with intra-operative stent implantation and a control group with standalone FESS. The Sino-Nasal Outcome Test 22, Lund-Kennedy scores and nasal secretion Matrix Metalloproteinase-9 (MMP-9) were assessed pre-operatively, and 3 and 12 months post-operatively. Data were analysed by SPSS 27.0 (p < 0.05 for significance).
RESULTS: All indicators decreased post-operatively in both groups (p < 0.05). MMP-9 reduction was similar at 3 months (p > 0.05); at 12 months, the experimental group had greater MMP-9 reduction and more significant decreases in related symptom scores (p < 0.05).
CONCLUSION: Intra-operative middle meatus drug-eluting stent implantation may provide additional benefits compared with standalone FESS in improving subjective symptoms, accelerating nasal mucosal repair and inhibiting inflammation within 12 months of follow up.