等离子射频消融联合下鼻甲骨折外移术治疗慢性肥厚性鼻炎的临床观察

Clinical observation on the treatment of chronic hypertrophic rhinitis by plasma radiofrequency ablation combined with outerfracture of the inferior turbinate

目的研究探讨等离子射频消融联合下鼻甲骨折外移术治疗慢性肥厚性鼻炎的临床观察。方法选取2021年1月至2022年10月接受治疗的180例慢性肥厚性鼻炎为研究对象,经随机数字表法分为2组,对照组(90例)采用鼻内镜下下鼻甲部分切除术治疗,观察组(90例)患者给予等离子射频消融联合下鼻甲骨折外移术治疗。观察对比2组治疗后的情况(临床指征、总有效率、Lund-Mackey鼻窦CT评分、并发症发生率)。结果观察组患者的总有效率(98.89%VS 88.89%)更佳(t=7.8429,P<0.05);观察组患者的鼻腔出血、鼻腔粘连、鼻腔干燥等并发症发生率(1.11%VS 7.78%)明显更低(t=4.7093,P<0.05);观察组患者的出血量少,术后鼻腔疼痛时间、下鼻甲肿胀时间短,VAS评分明显较对照组低(t=6.719、11.252、9.044、6.034,P<0.05);治疗后,2组Lund-Mackey鼻窦CT评分均已下降,比较发现研究组降幅大于对照组(P<0.05)。结论等离子射频消融联合下鼻甲骨折外移术治疗慢性肥厚性鼻炎的临床效果显著,不仅术中出血量少,而且术后鼻腔疼痛、下鼻甲肿胀时间短,可减轻疼痛感,有效缓解症状,非常具有临床价值,值得推荐。

Objective To investigate the clinical observation of plasma radiofrequency ablation combined with outerfracture of the inferior turbinate in the treatment of chronic hypertrophic rhinitis.Methods A total of 180 patients with chronic hypertrophic rhinitis treated in our department from January 2021 to October 2022 were recruited.They were randomly divided into control group(n=90)and observation group(n=90)by digital table method.Partial resection of inferior turbinate under nasal endoscope,and plasma radiofrequency ablation combined with outerfracture of the inferior turbinate were performed in the control group and the observation group,respectively.Postoperative clinical indications,total effective rate,Lund-Mackey score on sinus CT scan,and complication rate were compared between groups.Results The total effective rate in the observation group was significantly higher than that in the control group(98.89%vs 88.89%,t=7.8429,P<0.05).The incidence of complications like nasal bleeding,nasal adhesion,and nasal dryness in the observation group was significantly lower than that in the control group(1.11%vs 7.78%,t=4.7093,P<0.05).Patients in the observation group had less bleeding volume([9.57±1.05]ml),shorter time of postoperative nasal pain([1.35±0.49]d),shorter duration of the inferior turbinate swelling([5.35±1.69]d),and lower Visual Analogue Scale(VAS)scores([2.19±0.54]points)than those in the control group(t=6.719,11.252,9.044,and 6.034,respectively;P<0.05).After treatment,the Lund-Mackey score on sinus CT scan in both groups decreased,which was more pronounced in the observation group than that in the control group(P<0.05).Conclusion Plasma radiofrequency ablation combined with outerfracture of the inferior turbinates has a significant clinical effect on the treatment of chronic hypertrophic rhinitis.It not only has a small amount of intraoperative bleeding,but also has a short time for postoperative nasal pain and inferior turbinate swelling,which can alleviate pain and effectively alleviate symptoms.It is highly valuable and worth recommending.