Purpose:To assess the potential benefit of impregnating Merocel(a non-absorbable nasal dressing)with a topical steroid solution,for use as a direct and slow local delivery system of steroids after sinus surgery to imp...Purpose:To assess the potential benefit of impregnating Merocel(a non-absorbable nasal dressing)with a topical steroid solution,for use as a direct and slow local delivery system of steroids after sinus surgery to improve postoperative wound healing.Methods:In this randomized controlled trial,40 patients with bilateral chronic rhinosinusitis with nasal polyposis were subjected to functional endoscopic sinus surgery.Following the completion of the surgery,Merocel packs were inserted in the bilateral nasal cavities and infiltrated with 4 mL triamcinolone(40 mg/mL)in one nasal cavity(treatment group)and 4 mL normal saline in the other(control group).Nasal packs were removed on the third postoperative day and postoperative healing assessment was done on postoperative Weeks 1,2,4,and 12.The findings were noted as per Lund Kennedy(LKES)and perioperative sinus endoscopy(POSE)scores and compared on both sides.Results:Significant(P<0.05)improvement was noted in Lund Kennedy score for crusting and polyp at Week 12,for edema at Week 1,and nasal discharge at Weeks 1 and 12,but there was no significant improvement in scarring at any week.Overall,the difference between the treatment and control arms was statistically significant at all postoperative visits except at Week 4.Also,there was a significant improvement in POSE scores at Weeks 1,2,and 12 but not at Week 4.Conclusion:This study positively concludes that the nasal cavity packed with drug-soaked packs had less scarring and edema in the postoperative period and the overall wound healing was much better as compared to saline-soaked packs.展开更多
目的 探讨采用Lund概念提出的新型治疗方法能否降低严重颅脑损伤患者的病死率.方法 将68例格拉斯哥昏迷评分（GCS）3～8分的严重颅脑损伤患者按照随机原则分为对照组（38例）和Lund组（30例）.对照组以常规治疗方法控制颅内压（ICP）;L...目的 探讨采用Lund概念提出的新型治疗方法能否降低严重颅脑损伤患者的病死率.方法 将68例格拉斯哥昏迷评分（GCS）3～8分的严重颅脑损伤患者按照随机原则分为对照组（38例）和Lund组（30例）.对照组以常规治疗方法控制颅内压（ICP）;Lund组采用Lund概念提供的治疗措施,术后5 d连续监测ICP、脑灌注压（CPP）.结果 Lund组5 d甘露醇用量（g）较对照组明显减少（139.6±25.0比587.5±31.8,P＜0.01）;Lund组28 d病死率显著低于对照组（30.0%比57.9%,P＜0.05）.Lund组中死亡者（9例）ICP＞25 mm Hg（1 mm Hg=0.133 kPa）、ICP＞35 mm Hg、CPP＜50 mm Hg的比例显著高于生存者[21例,分别为（45.0±23.2）%比（7.2±3.6）%,（40.2±18.6）%比（2.2±1.6）%,（35.9±12.9）%比（3.1±2.4）%,均P＜0.05].结论 采用Lund概念治疗方法能降低严重颅脑损伤患者颅脑手术后的病死率.展开更多
文摘Purpose:To assess the potential benefit of impregnating Merocel(a non-absorbable nasal dressing)with a topical steroid solution,for use as a direct and slow local delivery system of steroids after sinus surgery to improve postoperative wound healing.Methods:In this randomized controlled trial,40 patients with bilateral chronic rhinosinusitis with nasal polyposis were subjected to functional endoscopic sinus surgery.Following the completion of the surgery,Merocel packs were inserted in the bilateral nasal cavities and infiltrated with 4 mL triamcinolone(40 mg/mL)in one nasal cavity(treatment group)and 4 mL normal saline in the other(control group).Nasal packs were removed on the third postoperative day and postoperative healing assessment was done on postoperative Weeks 1,2,4,and 12.The findings were noted as per Lund Kennedy(LKES)and perioperative sinus endoscopy(POSE)scores and compared on both sides.Results:Significant(P<0.05)improvement was noted in Lund Kennedy score for crusting and polyp at Week 12,for edema at Week 1,and nasal discharge at Weeks 1 and 12,but there was no significant improvement in scarring at any week.Overall,the difference between the treatment and control arms was statistically significant at all postoperative visits except at Week 4.Also,there was a significant improvement in POSE scores at Weeks 1,2,and 12 but not at Week 4.Conclusion:This study positively concludes that the nasal cavity packed with drug-soaked packs had less scarring and edema in the postoperative period and the overall wound healing was much better as compared to saline-soaked packs.
文摘目的 探讨采用Lund概念提出的新型治疗方法能否降低严重颅脑损伤患者的病死率.方法 将68例格拉斯哥昏迷评分（GCS）3～8分的严重颅脑损伤患者按照随机原则分为对照组（38例）和Lund组（30例）.对照组以常规治疗方法控制颅内压（ICP）;Lund组采用Lund概念提供的治疗措施,术后5 d连续监测ICP、脑灌注压（CPP）.结果 Lund组5 d甘露醇用量（g）较对照组明显减少（139.6±25.0比587.5±31.8,P＜0.01）;Lund组28 d病死率显著低于对照组（30.0%比57.9%,P＜0.05）.Lund组中死亡者（9例）ICP＞25 mm Hg（1 mm Hg=0.133 kPa）、ICP＞35 mm Hg、CPP＜50 mm Hg的比例显著高于生存者[21例,分别为（45.0±23.2）%比（7.2±3.6）%,（40.2±18.6）%比（2.2±1.6）%,（35.9±12.9）%比（3.1±2.4）%,均P＜0.05].结论 采用Lund概念治疗方法能降低严重颅脑损伤患者颅脑手术后的病死率.
