Hiệu quả của việc sử dụng corticosteroid tại chỗ trước phẫu thuật nội soi mũi xoang=Effect of preoperative treatment with topical corticosteroid before endoscopic sinus surgery

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Ngọc Hân Nguyễn, Thị Ngọc Dung Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.147-153

Bộ sưu tập: Metadata

ID: 243662

Thêm vào giỏ

Tìm hiểu xem việc sử dụng corticosteroid tại chỗ trước phẫu thuật có thực sự giúp cải thiện chất lượng phẫu trường, cũng như giảm chảy máu trong phẫu thuật nội soi mũi xoang hay không. Phương pháp: Nghiên cứu mô tả hàng loạt ca, can thiệp lâm sàng có đối chứng. 43 bệnh nhân được chẩn đoán viêm mũi xoang mạn có polyp mũi và được phẫu thuật nội soi mũi xoang tại Bệnh viện Tai Mũi Họng Thành phố Hồ Chí Minh từ tháng 9/2022 đến tháng 12/2022, được chia làm hai nhóm: nhóm sử dụng corticosteroid tại chỗ (mometasone furoate 200 μg x 2 lần/ ngày trong 4 tuần trước phẫu thuật) và nhóm chứng (không sử dụng corticosteroid tại chỗ trước phẫu thuật). Đánh giá lượng máu mất trong phẫu thuật, chất lượng phẫu trường và thời gian phẫu thuật ở cả hai nhóm. Kết quả: Chất lượng phẫu trường (theo thang điểm Boezaart) của nhóm dùng thuốc (2,49 ± 0,39) thấp hơn nhóm chứng (2,82 ± 0,31) có ý nghĩa thống kê (p = 0,004). Tuy nhiên, lượng máu mất trung bình trong phẫu thuật ở nhóm dùng thuốc (266,67 ± 91,29 ml) ít hơn nhóm chứng (306,82 ± 77,61 ml), không có ý nghĩa thống kê (p = 0,074). Thời gian phẫu thuật ở nhóm dùng thuốc là 104,76 ± 20,46 phút và nhóm chứng là 120,00 ± 33,27 phút. Thời gian chênh lệch xấp xỉ 16 phút, tuy nhiên khác biệt không có ý nghĩa thống kê (p = 0,196). Kết luận: Nghiên cứu cho thấy việc sử dụng corticosteroid tại chỗ (mometasone furoate) trước phẫu thuật nội soi mũi xoang có thể giúp cải thiện chất lượng phẫu trường.To find out whether the preoperative use of a topical corticosteroid could really improve the surgical field quality and decrease bleeding during endoscopic sinus surgery. Methods: Study design: case series, controlled clinical trial. 43 patients with chronic rhinosinusitis with polyps underwent endoscopic sinus surgery at Ho Chi Minh City Ear Nose Throat hospital from September 2022 to December 2022, allocated to two groups: intranasal corticosteroid users (mometasone furoate 200 μg, twice a day during four weeks within the preoperative period) and control group (intransal corticosteroid nonusers). Total blood loss, surgical field quality and operation time were recorded. Results: Boezaart scores for surgical field in the treatment group (2.49 ± 0.39) was significantly lower than control group (2.82 ± 0.31). Intraoperative blood loss in the treatment group was 266.67 ± 91.29 ml, less than in the control group (306.82 ± 77.61 ml), but not significantly (p = 0.074). Time of surgery was 104.76 ± 20.46 minutes in the treatment group and 120.00 ± 33.27 minutes in the control group. The difference was approximately 16 minutes, which is not statistically significant (p = 0.196). Conclusion: In our experience, the use of topical corticosteroid (mometasone furoate) in the preoperative period can improve endoscopic vision in chronic rhinosinusitis patients with polyps undergoing endoscopic sinus surgery.

1. Đọc trực tuyến

1. Đọc trực tuyến

Tạo bộ sưu tập với mã QR