三种不同术式治疗慢性肥厚性鼻炎的疗效比较

Comparison of therapeutic effects of three different surgeries on chronic hypertrophic rhinitis

目的:综合评价动力系统下鼻甲成形术(PAT)、下鼻甲粘骨膜下切除术(CST)、下鼻甲部分切除术(PIT)三种术式对慢性肥厚性鼻炎(CHR)的效果。方法:慢性肥厚性鼻炎患者90例随机分为3组,其中施行PAT30例,CST30例,PIT30例。记录3组的手术时间、术中出血量;3组患者手术前后分别用声反射鼻测量计(AR)检测鼻腔最小横截面积(MCA),糖精法检测粘液纤毛传输速率(MTR)。同时选取健康人10例作对照组,术后随访3个月。结果:PAT、CST和PIT组的平均手术时间各组间比较均有显著性差异(P<0.01～0.05);出血量PAT和CST组比PIT组显著减少(P<0.01);PAT、CST和PIT组MCA术后与术前比较显著增加(P<0.01);除PIT组外,PAT与CST组鼻腔MTR术后与术前比较有显著性差异(P<0.01)。结论:与CST和PIT比较,PAT具有切除快、出血少、术后鼻腔通气、粘液纤毛传输功能恢复好等优点,是三种术式中最佳的一种。

Objective：To evaluate the therapeutic effects of powered - assisted turbinoplasty（PAT）, conventional submuoous techniques（CST） and partial inferior turbinectomy（PIT） on chronic hypertrophic rhinitis（CHR）. Methods ：90 patients with CHR were randomly divided into three greups（30 cases underwent PAT,30 ones underwent CST and 30 ones underwent PIT）and 10 healthy people were selected as the control. All patients received the examinations of minimal cross - sectional area（MCA） of the nasal cavity by acoustic rhinometry（AR） and saccharin method was used to detect mucociliary transmission rate （MTR） before and after the surgery. All of them were followed up for 3 months after the surgery. Results ： There were significant differences of the operative time among three groups （ P 〈 0.01 - 0.05 ）. The intraoperative blood losses in both PAT group and CST group were significantly lower than that in PIT group （P 〈 0.01 ）. The MCAs in three groups increased after the surgery compared with those before the surgery（ P 〈 0.01 ）. MTR of both PAT group and CST group improved significantly after the surgery （ P 〈 0.01 ）. Conclusion： Compared with PIT and CST, PAT has the advantages of shorter operative time, less blood loss, and better mucociliary transmission function as well as ventilation function. Therefore, PAT is a better surgical method than other two methods.