Optimal duration of macrolide treatment for chronic sinusitis after endoscopic sinus surgery.
Optimal duration of macrolide treatment for chronic sinusitis after endoscopic sinus surgery.
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内窥镜鼻窦手术后大环内酯类药物治疗慢性鼻窦炎的最佳持续时间。
DOI：
10.1016/j.anl.2012.09.009
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发表时间：
2013
影响因子：
1.7
通讯作者：
Ohno N
中科院分区：
文献类型：
--
作者：
Nakamura Y;Suzuki M;Yokota M;Ozaki S;Ohno N
目的是确定适当的持续时间的术后大环内酯类药物治疗慢性鼻窦炎，以获得一个良好的结果与内窥镜鼻窦手术（ESS）。方法术后大环内酯类药物治疗的有效性进行了检查，慢性鼻窦炎患者进行ESS，通过比较3个月（44例）和6个月（66例）的克拉霉素（CAM）（200毫克/天）。根据术后3、6和12个月的主观症状和内窥镜检查结果进行评估，17名（3个月CAM组）和22名（6个月CAM组）受试者能够在术后随访至12个月。术后6个月时，两组的有效性无差异，但术后12个月时，6个月治疗组的溢液和鼻后滴涕主观症状消失率显著较高，视觉模拟量表（VAS）评分显著较低。术后12个月时，6个月治疗组鼻后滴涕的内镜检查阳性率也显著较低。随着时间的推移，这些变化表明CAM治疗在3个月的治疗组中停止后逐渐恶化，而一个小的改善后，观察到在6个月的治疗group.CONCLUSIONThe结果表明，慢性鼻窦炎患者溢液或后鼻滴应与大环内酯类药物治疗6个月后，手术，以改善长期的结果内窥镜鼻窦手术。
OBJECTIVEThe objective is to determine the appropriate duration of postoperative macrolide therapy for chronic rhinosinusitis to obtain a favourable outcome with endoscopic sinus surgery (ESS).METHODSThe effectiveness of postoperative macrolide treatment was examined in patients with chronic rhinosinusitis who underwent ESS, by comparing 3-month (44 patients) and 6-month administration (66 patients) of clarithromycin (CAM) (200mg/day). Evaluation was made based on subjective symptoms and endoscopic findings at 3, 6 and 12 months after surgery.RESULTSSeventeen (3-month CAM group) and 22 (6-month CAM group) subjects were able to be followed up to 12 months after surgery. No difference in effectiveness was observed between the groups until 6 months after surgery, but the 6-month treatment group showed significantly higher disappearance rates and significantly lower visual analogue scale (VAS) scores in the subjective symptoms of rhinorrhea and postnasal drip at 12 months after surgery. The positive finding rate of postnasal drip by endoscopic examination was also significantly lower in the 6-month treatment group at 12 months after surgery. These changes over time indicated gradual deterioration after discontinuation of CAM treatment in the 3-month treatment group, whereas a small improvement was observed after discontinuation in the 6-month treatment group.CONCLUSIONThe results indicate that chronic sinusitis patients with rhinorrhea or postnasal drip should be treated with macrolides for 6 months after surgery in order to improve the long-term outcome of endoscopic sinus surgery.