关键词: 慢性乙型肝炎, 慢性鼻窦炎, 鼻内镜手术, 医用交联透明质酸钠凝胶, 治疗

Abstract: Objective The aim of this study was to investigate wound healing efficacy of cross-linked hyaluronan gel in patients with chronic hepatitis B (CHB) and chronic rhinosinusitis (CRS) undergoing endoscopic sinus surgery. Methods A prospective,randomized controlled trial was conducted on 33 patients with CHB and bilateral CRS, with or without nasal polyps in Beijing You'an Hospital between January 2022 and October 2024, and all patients underwent bilateral endoscopic sinus surgery. For nasal packing after operation, patients were randomized to receive cross-linked hyaluronan gel along with degradable hemostatic sponge in one nasal cavity in observation group or to receivedegradable hemostatic sponge alone contralaterally in control. All patients were followed-up for 12 weeks postoperatively. Visual analogue scale (VAS) scores for symptoms, endoscopic sinus Lund-Kennedy scores and bleeding scores based on Boezaart criteria were recorded. Results Two patients were lost to follow-up in our series, left 31 patients ultimately completing routine follow-up; by week 1, 2, 4, 8 and 12, LKES scores in the observation group were (3.1±0.9), (2.5±1.0), ( 2.0±1.0), (1.6±1.0) and (0.9±0.8), all significantly lower than [(4.2±1.3), (3.7±1.2), (3.2±1.2), (2.5±0.9) and (1.5±0.9), respectively, P<0.05]in the control; by end of week 4, 8 and 12, incidences of local adhesion in the observation were 25.8%, 32.2% and 12.9%, all much lower than 48.4%, 58.1% and 29.0%(P<0.05) in the control group; by day 3, week 1, 2, 4 and 8 after operation, no statistically significant differences were found as respect to nasal bleeding scores(P>0.05)between the two groups. Conclusion We recommend the cross-linked hyaluronan gel for nasal packing in patients with CHB and CRS, which could promote rapid wound healing and reduce synechia after endoscopic sinus surgery.

Key words: Hepatitis B, Chronic rhinosinusitis, Endoscopic sinus surgery, Cross-linked hyaluronan gel, Surgery