鼻内镜下高选择性鼻部神经阻断术治疗中、重度变应性鼻炎疗效观察

Clinical effect of nasal endoscopic high selective nasal nerve blocking in the treatment of moderate and severe allergic rhinitis

目的探讨鼻内镜下高选择性鼻部神经(翼管神经鼻后神经丛+咽支+筛前神经分支)阻断术治疗中、重度变应性鼻炎的临床疗效。方法回顾性分析于北部战区空军医院耳鼻喉科自2017年1月至2019年12月行高选择性鼻部神经阻断术的32例中、重度变应性鼻炎患者的临床资料。记录并比较患者术前、术后主观症状视觉模拟量表(VAS)评分、过敏性鼻炎鼻结膜炎生存质量(RQLQ)评分。结果所有患者均顺利完成治疗和随访,随访率100.0%(32/32),均无严重并发症发生。与术前比较,术后3个月与术后2年患者的主观症状VAS评分及生活质量RQLQ评分均显著降低,差异均有统计学意义(P<0.05)。术后2年的整体有效率为87.5%(28/32),低于术后3个月的100.0%(32/32),但差异无统计学意义(P>0.05)。结论鼻内镜下高选择性鼻部神经阻断术治疗中、重度变应性鼻炎患者临床效果良好,是一种安全、有效的治疗方式。

Objective To investigate the clinical effect of nasal endoscopic high selective nasal nerve blocking(pterygoid nerve posterior plexus+pharyngeal branch+anterior ethmoid nerve branch)in the treatment of moderate and severe allergic rhinitis.Methods A retrospective study was performed on 32 cases of patient with moderate and severe allergic rhinitis who were admitted and underwent nasal endoscopic high selective nasal nerve blocking from January 2017 to December 2019.Preoperative and postoperative visual analogue scale(VAS)scores and rhinoconjunctivitis quality of life questionnaire(RQLQ)scores for allergic rhinitis and rhinoconjunctivitis were recorded and compared.Results All patients were successfully treated and followed up,with a follow-up rate of 100.0%(32/32),and no serious surgical complications occurred.Compared with preoperative results,subjective symptom VAS score and quality of life RQLQ score were significantly reduced in patients 3 months and 2 years after surgery,and the differences were statistically significant(P<0.05).The overall effective rate was 87.5%(28/32)2 years after surgery,slightly lower than 100.0%(32/32)3 months after surgery,but the difference was not statistically significant(P>0.05).Conclusion Nasal endoscopic high selective nasal nerve blocking is a safe and effective treatment for moderate and severe allergic rhinitis with good clinical results.