【摘要】 目的:评价3D打印导航式鼻窦精准给药器在治疗嗜酸性粒细胞型慢性鼻窦炎伴鼻息肉(CRSwNP)术后的疗效。方法:收集鼻内镜术后病理诊断为嗜酸性粒细胞型CRSwNP 68例，随机分为对照组和观察组，各34例。对照组按常规方法使用鼻用糖皮质激素喷鼻治疗；观察组采用3D打印导航式鼻窦精准给药器行鼻用糖皮质激素局部给药治疗。对比分析术后1、3、6个月及1年时鼻内镜Lund-Kennedy评分分级、22项鼻腔鼻窦结局试验(SNOT-22)量表评分。结果:两组间鼻息肉大小、鼻黏膜水肿及鼻漏评Lund-Kennedy评分分级在术后1个月时比较差异无统计学意义(均P>0.05),术后3、6个月、1年时观察组低于对照组，差异有统计学意义(均P<0.05)。两组间术后1个月时SNOT-22评分比较差异无统计学意义(P>0.05),术后3、6个月、1年时观察组低于对照组，差异有统计学意义(均P<0.05)。两组患者术后用药1年时检测血浆皮质醇水平均正常，且组间比较差异无统计学意义(P>0.05)。结论:采用3D打印导航式鼻窦精准给药器在控制嗜酸性粒细胞型CRSwNP术后复发及提高患者生活质量中效果显著，其疗效优于常规鼻喷激素鼻腔喷鼻治疗，且安全可靠。更多还原

【Abstract】 Objective:To evaluate the efficacy of precise 3D printed track-guided drug delivery for sinus in eosinophilic chronic rhinosinusitis with nasal polyps(CRSwNP)after operation.Methods:A total of 68 patients with eosinophilic CRSwNP diagnosed by pathology after endoscopic sinus surgery were randomly divided into control group and observation group, 34 cases in each group.The control group was treated with nasal glucocorticoid spray according to the conventional method.The observation group was treated with 3D printed track-guided drug delivery for nasal glucocorticoid local administration.The Lund-Kennedy score of nasal endoscopy and the scores of SNOT-22 scale at 1,3,6 months and 1 year after surgery were compared and analyzed.Results:There was no significant difference in Lund-Kennedy scores of the size of nasal polyps, nasal mucosal edema and of rhinorrhea between the two groups at 1 month after surgery(all P>0.05).The scores in the observation group were lower than those in the control group at 3 months, 6 months and 1 year after surgery(all P<0.05).There was no significant difference in SNOT-22 score between the two groups at 1 month after operation(P>0.05),while the observation group was lower than the control group at 3 months, 6 months and 1 year after operation(all P<0.05).The plasma cortisol level of the two groups was normal at 1 year after medication, and there was no significant difference between the two groups(P>0.05).Conclusion:The precise 3D printed track-guided drug delivery for sinus has a significant effect in controlling the recurrence of eosinophilic CRSwNP after surgery and improving the quality of life of patients, and its curative effect is better than that of conventional nasal spray hormone treatment, also it is safe and reliable.更多还原