CAJ | 학술논문

目的分析克拉霉素对细菌生物膜表达阳性慢性鼻-鼻窦炎(CRS)患者术后疗效的影响 .方法选择2008年1月-2009年12月在金华市中心医院耳鼻咽喉科进行内镜下鼻窦手术的细菌生物膜阳性的CRS患者77例.其中42例患者在术后第3周起口服克拉霉素250 mg/d,持续至少3个月.治疗3个月时行鼻内镜检查,术腔黏膜上皮化的患者,可停用克拉霉素；对术腔黏膜局部肿胀、肉芽或息肉形成及有脓性分泌物的患者,建议继续口服克拉霉素,直至患者术腔黏膜恢复正常,但总持续时间＜5月.另35例患者未予克拉霉素治疗.应用视觉模拟量表(VAS)及鼻内镜检查(Lund-kennedy评分)评估患者术后6个月病情改善程度.t检验分析克拉霉素对细菌生物膜表达阳性患者疗效的影响.结果克拉霉素治疗组42例患者中有2例因不同原因退出本研究.克拉霉素治疗组40例患者术后6个月VAS评分和Lund-kennedy评分分别为(8.0±0.8)分和(3.6±1.3)分,而对照组为(7.3±0.7)分和(4.5±1.7)分,差异有统计学意义(t=5.311和-3.187,P值均＜0.01).结论小剂量、长期克拉霉素口服治疗能提高细菌生物膜阳性慢性鼻-鼻窦炎患者的术后疗效.
목적 분석극랍매소대세균생물막표체양성만성비-비두염(CRS)환자술후료효적영향 .방법 선택2008년1월-2009년12월재금화시중심의원이비인후과진행내경하비두수술적세균생물막양성적CRS환자77례.기중42례환자재술후제3주기구복극랍매소250 mg/d,지속지소3개월.치료3개월시행비내경검사,술강점막상피화적환자,가정용극랍매소；대술강점막국부종창、육아혹식육형성급유농성분비물적환자,건의계속구복극랍매소,직지환자술강점막회복정상,단총지속시간＜5월.령35례환자미여극랍매소치료.응용시각모의량표(VAS)급비내경검사(Lund-kennedy평분)평고환자술후6개월병정개선정도.t검험분석극랍매소대세균생물막표체양성환자료효적영향.결과 극랍매소치료조42례환자중유2례인불동원인퇴출본연구.극랍매소치료조40례환자술후6개월VAS평분화Lund-kennedy평분분별위(8.0±0.8)분화(3.6±1.3)분,이대조조위(7.3±0.7)분화(4.5±1.7)분,차이유통계학의의(t=5.311화-3.187,P치균＜0.01).결론 소제량、장기극랍매소구복치료능제고세균생물막양성만성비-비두염환자적술후료효.
Objective To evaluate the efficacy of low-dose and long-term clarithromycin in treatment of chronic rhinosinusitis with positive bacterial biofilms.Methods Seventy-seven patients with chronic rhinosinusitis and positive bacterial biofilms underwent functional endoscopic sinusitis surgery between January 2008 and December 2009 in department of otolaryngology of Jinhua Central Hospital.Fortytwo patients were treated with clarithromycin 250 mg/d orally for at least 3 months (trial group).At the end of 3 months patients received endoscopic examination,for patients with mucosal epithelialization the clarithromycin therapy was stopped; for those with mucosal edema,granulation or polyoid formations the clarithromycin treatment was continued,but no longer than 5 months.Thirty-five patients in control group were not given clarithromycin.All patients were assessed by visual analogue scale (VAS) and nasal endoscopic examination (Lund-kennedy score) 6 months after surgery,the results were compared between two groups.Results Two patients in the trial group did not complete the protocol.VAS score and Lundkennedy score in trial group were 8.0 ± 0.8 and 3.6 ± 1.3 at 6 month after surgery respectively,while those in the control group were 7.3 ± 0.7 and 4.5 ± 1.7,and the differences were of statistical significance (t =5.311 and-3.187,P ＜ 0.01).Conclusion Low-dose and long-term oral administration of clarithromycin has positive impact on the prognosis of bacterial biofilms positive patients with chronic rhinosinusitis.