中国耳鼻咽喉头颈外科2025，Vol.32Issue(3)：164-168,5.DOI:10.16066/j.1672-7002.2025.03.006
缓释糖皮质激素支架在慢性鼻窦炎伴鼻息肉内镜术中的应用及疗效观察
Application and efficacy of Bioabsorbable steroid-eluting sinus stent in endoscopic treatment of chronic rhinosinusitis with nasal polyps
摘要
Abstract
OBJECTIVE To observe the efficacy of Bioabsorbable steroid-eluting sinus stent implantation in endoscopic treatment of chronic rhinosinusitis with nasal polyps(CRSwNP).METHODS In a self-controlled study,25 patients with CRSwNP who underwent nasal endoscopic surgery were randomly assigned to implant a Bioabsorbable steroid-eluting sinus stent into one side of the ethmoid sinus after nasal endoscopic surgery,leaving one side of the ethmoid sinus without stent implantation.Follow-up and endoscopic evaluation were performed before surgery,2 weeks,1 month,2 months,and 3 months after surgery.Main outcome measures:visual analogue scale(VAS)score,Lund-Kennedy endoscopic score,eosinophils(Eos)count in mucosal tissue,nasal discharge smear,postoperative intervention.RESULTS The Lund-Kennedy endoscopy score on the stent side was significantly lower than that on the control side at 1 and 3 months after surgery.There was no significant difference between the VAS scores of the stent side and the control side.One month after surgery,the Eos count of nasal mucosa pathology and Eos level of nasal secretions smear in patients with eosinophilic CRSwNP(eCRSwNP)and non-eosinophilic CRSwNP(neCRSwNP)on the stent side were significantly lower than those in the control side.However,there was no significant difference between eCRSwNP patients and neCRSwNP patients in the improvement degree of Eos count in nasal mucosa pathology and nasal secretions smear 1 month after stent operation.The ratio of requiring surgical intervention 1 month after surgery was lower in the neCRSwNP group than in the control group,while there was no significant difference between the two sides in the eCRSwNP group.The polypoid tissue score in neCRSwNP group were significantly lower than those in eCRSwNP group one month after surgery,the ratio of bilateral intervention in neCRSwNP group were lower than those in eCRSwNP group one month after surgery,with a significant difference on the stent side.CONCLUSION The application of Bioabsorbable steroid-eluting sinus stent in nasal endoscopy can improve the nasal endoscopy score,reduce the Eos inflammatory load,reduce surgical intervention,and thus improve the early postoperative outcome.Stent implantation can benefit both eCRSwNP patients and neCRSwNP patients.eCRSwNP patients with high inflammation burden may require more effective stents and release higher doses of corticosteroids to achieve higher benefits.关键词
鼻窦炎/鼻息肉/嗜酸细胞/药物洗脱支架/糖皮质激素类Key words
Sinusitis/Nasal Polyps/Eosinophils/Drug-Eluting Stents/Glucocorticoids引用本文复制引用
李晶,纪文君,惠奕,王鑫..缓释糖皮质激素支架在慢性鼻窦炎伴鼻息肉内镜术中的应用及疗效观察[J].中国耳鼻咽喉头颈外科,2025,32(3):164-168,5.基金项目
苏州高新区医疗卫生科技计划重点项目(2019Z001) （2019Z001）
