HO-YAG激光在鼻内镜鼻窦手术中的应用

APPLICATION OF HO-YAG LASER IN TREATING NASAL SINUSITIS THROUGH NASAL SPECULUM

目的探讨HO-YAG激光在鼻内镜鼻窦手术中彻底清除病灶,减少粘膜损伤及术中出血量的应用。方法选择2000年～2004年临床慢性鼻窦炎Ⅱ、Ⅲ型病例176例,随机分为A组96例,采用鼻内镜手术配合HO-YAG激光治疗;B组80例,行单纯鼻内镜手术。术后统计分析两组的出血量、手术时间及HO-YAG激光组8周内上皮化与常规组的比较。结果两组治疗后平均出血量及手术时间分别是A组为70.65±50.25ml,46.75±4.38min;B组为115.78±60.42ml,70.56±20.12min治愈率A组为81.25%,B组为71.25%。8周内术腔上皮化A组为67.7%,B组为37.5%。结论慢性鼻窦炎Ⅱ、Ⅲ型在施行鼻内镜手术时,配合HO-YAG激光处理术中出血及清除病灶,能明显减少出血量,保持术区清晰,去除病灶彻底并减少正常组织损伤,缩短手术时间,提高治愈率,缩短病程。

Objective： To investigate the effect of HO - YAG laser in ridding of the diseased foci thoroughly, keeping mucous membrane intact and lessening bleeding. MethOdS： 176 cases of Type Ⅱ ＆ Ⅲ chronic nasosinusitis admitted from the year 2000 to 2004 were selected and divided randomly into Group A and Group B. Group A ： 96 cases, receiving operations through rhinoscope with HO - YAG laser therpy. Group B ： 80 cases, receiving operations through rhinoscope merely. Post- operation comparison study between these two methods was done. The epitheliogenic state within 8 weeks was also compared. Results： Averge bleeding amount and operation time： Group A 70.65 ± 50.25 ml,46.75±4.38 min; Group B 115.78 ± 60.42 ml, 70.56 ± 20.12min, cure rate： Group A 81.25 %, Group B 71.25 %. epitheliogenic state within 8 weeks of the operational area： Group A 67.7%, Group B 37.5%. Conclusion： Operation through nasal speculum coordinated with HO- YAG therpy wiU lessen the bleeding amount obviously, keep good exposure, get rid of the diseased feci thoroughly without damage to normal tissue, shorten the operation time, and the course of the disease and raise the cure rate.