下鼻甲外移联合低温等离子消融术治疗慢性肥厚性鼻炎疗效分析

Effect of inferior turbinate outfracture combined with low-temperature plasma radiofrequency ablation on chronic rhinitis

目的探讨下鼻甲外移联合低温等离子消融术对以鼻塞为主要症状的成人慢性肥厚性鼻炎患者的主观症状、鼻腔黏膜纤毛清除功能及鼻阻力的疗效。方法将门诊诊断为慢性肥厚性鼻炎的76例患者分为手术组和药物组,分别行下鼻甲外移联合低温等离子消融术治疗和等渗盐水鼻腔冲洗加鼻内糖皮质激素治疗。治疗后1年检测患者主观症状、黏膜纤毛清除时间及鼻阻力变化,并与治疗前进行对比分析。结果治疗前患者平均糖精清除时间为17.42min;治疗后手术组患者平均糖精清除时间为17.47min,药物组患者平均糖精清除时间为16.82min,手术组与药物组比较差异无统计学意义(P>0.05)。鼻阻力检测示,手术组鼻阻力明显减小,且其减小程度与药物组比较差异具有统计学意义(P<0.01)。与治疗前相比,视觉模拟量表(VAS)评分示手术组患者鼻塞症状明显改善(P<0.05),且改善程度优于药物组。结论下鼻甲外移联合低温等离子消融术治疗对慢性肥厚性鼻炎患者鼻腔黏膜清除功能影响不明显,但可显著减小鼻阻力,且对患者主观症状改善明显。

Objective To determine the effect of inferior turbinate outfracture combined with low-temperature plasma radiofrequency ablation （LTPRA） on chronic rhinitis.Method Seventy-six patients with chronic rhinitis were divided randomly into two groups, the treatment group undertaken inferior turbinate outfracture combined with LTPRA, and the control group received saline nasal irrigation and intranasal corticosteroid treatment. The subjective symptoms and nasal resistance were assessed before and one year after treatment respectively.Results Before treatment, the total average mucociliary clearance time was 17.42 min. One year after treatment, the mucociliary clearance time of inferior turbinate outfracture combined with LTPRA group was 17.47 min, which was insignificantly different from that of the control group （16.82 min） （P〉0.05）. Compared to parameters before treatment, the nasal resistance was significantly decreased in inferior turbinate outfracture combined with LTPRA group （P〈0.01）, and visual analogue scale （VAS） evaluation showed inferior turbinate outfracture combined with LTPRA treatment significantly improved subjective symptoms （P〈0.01）. The differences in decrease of nasal resistance and improvement of subjective symptoms between the inferior turbinate outfracture combined with LTPRA group and the control group were statistically significant （bothP〈0.01）.Conclusions Inferior turbinate outfracture combined with LTPRA can significantly decrease nasal resistance and improve subjective symptoms, and therefore is safe and effective for chronic rhinitis.