鼻内镜Messerklinger中鼻甲成形术与鼻内镜中鼻甲部分切除术治疗慢性鼻-鼻窦炎伴鼻息肉的效果比较

Comparison on curative effects of endoscopic Meserklinger middle turbinoplasty versus endoscopic partial turbinectomy on chronic rhinosinusitis with nasal polyps

目的比较鼻内镜Messerklinger中鼻甲成形术与鼻内镜中鼻甲切除术治疗慢性鼻-鼻窦炎伴鼻息肉(CRSwNP)的临床效果。方法抽取2018年4月至2021年1月运城第一医院收治的80例CRSwNP患者,根据手术方法分为A组和B组,每组40例。B组接受鼻内镜中鼻甲部分切除术治疗,A组接受鼻内镜Messerklinger中鼻甲成形术治疗。比较两组的治疗效果、手术指标及术前、术后3个月嗅觉功能、鼻腔通气功能、最小横截面至前鼻孔距离(DCAN)、鼻腔最小横截面积面(NMCA)、鼻腔容积(NCV)、Lund-kennedy评分、鼻腔鼻窦结局测试-20量表(SNOT-20)评分。结果A组总有效率(95.00%,38/40)高于B组(75.00%,30/40),P<0.05。A组住院时间、手术时间均短于B组,术中出血量少于B组(P<0.05)。术后3个月,A组嗅觉功能、鼻腔通气功能优于B组(P<0.05),DCAN、NMCA、NCV优于B组(P<0.05),Lund-kennedy、SNOT-20评分低于B组(P<0.05)。结论与鼻内镜中鼻甲部分切除术相比,CRSwNP患者应用鼻内镜Messerklinger中鼻甲成形术治疗效果更佳,更利于优化手术指标及DCAN、NMCA、NCV指标,提高嗅觉功能、鼻腔通气功能及鼻腔黏膜功能,提高患者生活质量。

Objective To compare the effect of endoscopic Messerklinger middle turbinoplasty and endoscopic partial turbinectomy in the treatment of chronic rhinosinusitis with nasal polyps(CRSwNP).Methods Eighty CRSwNP patients treated in Yuncheng First Hospital from April 2018 to January 2021 were divided into group A and group B according to the operation methods,with 40 cases in each group.Group B received endoscopic partial turbinectomy,and group A received endoscopic Meserklinger middle turbinoplasty.The therapeutic effects and surgical indexes of the two groups were compared;olfactory function,nasal ventilation function,minimum cross section to anterior nostril distance(DCAN),minimum cross-sectional area of nasal cavity(NMCA),nasal cavity volume(NCV),Lund Kennedy score,nasal cavity and sinus outcome test-20 scale(SNOT-20)score were compared between the two groups before operation and 3 months after operation.Results The total effective rate of the group A was 95.00%(38/40),higher than the 75.00%(30/40)of the group B(P<0.05).The hospital stay and operation time in the group A were shorter than those in the group B,and the amount of intraoperative bleeding was less than that in the group B(P<0.05).Three months after operation,the olfactory function and nasal ventilation function of the group A were better than those of the group B(P<0.05),while DCAN,NMCA,NCV of the group A were better than those of the group B(P<0.05),moreover,the Lund-Kennedy and SNOT-20 scores were lower than those of the group B(P<0.05).Conclusions Compared with endoscopic partial turbinectomy,the treatment effect of endoscopic Messerklinger middle turbinoplasty is better in the treatment of CRSwNP,and it is more conducive to optimizing the perioperative indexes,DCAN,NMCA,and NCV;it can improve olfactory function,nasal ventilation function and nasal mucosal function,and improve the quality of life of patients.