等离子射频消融术在鼻腔手术中的联合应用

Combination application of radiofrequency ablation in nasal operation

目的:探讨在鼻腔手术中联合应用等离子射频消融术治疗下鼻甲肥大及变应性鼻炎的疗效。方法:91例伴下鼻甲肥大及变应性鼻炎的鼻中隔偏曲或鼻息肉患者,行鼻中隔成形术或鼻内镜下鼻息肉摘除加筛窦开放术后,其中62例行等离子射频消融术(消融组),29例未行等离子射频消融术(对照组)。术前及术后3个月应用视觉模拟评分表(VAS)评价鼻塞的主观感觉。根据1997年海口会议疗效评定标准判断变应性鼻炎的疗效。结果:消融组术前鼻塞VAS评分左、右侧分别为(89.5±8.7)%和(90.3±10.5)%,术后3个月分别为(26.2±8.7)%和(32.1±10.3)%,左、右侧分别与术前比较,差异有统计学意义(均P<0.01);32例变应性鼻炎患者,显效31例(96.9%),有效1例(3.1%)。对照组术前鼻塞VAS评分左、右侧分别为(90.5±8.0)%和(89.9±11.5)%,术后3个月分别为(39.2±8.9)和(48.1±8.1)%,左、右侧分别与术前比较,差异均有统计学意义(均P<0.01);16例变应性鼻炎患者,显效4例(25.0%),有效10例(62.5%),无效2例(12.5%)。两组术后VAS评分差异有统计学意义(P<0.01)。结论:在鼻腔手术中联合应用等离子射频消融术治疗下鼻甲肥大及变应性鼻炎安全、有效。

Objective：To investigate the clinical etticacy ol radlolrequency ablation in treating the inlerior turbinates hypertrophic and allergic rhinitis after septoplasty or nasal polypectomy. Method： Ninety-one patients with nasal septum deviation or nasal polyp with inferior turbinates hypertrophic and（or） allergic rhinitis were underwent septoplasty or nasal polypectomy. Sixty-two cases of 91 patients with inferior turbinates hypertrophic or allergic rhinitis underwent radiofrequency ablation,29 cases did not. The preoperative and postoperative nasal obstructions were investigated by visual analogue scale （VAS）. Allergic rhinitis symptoms were assessed by 1997s Haikou standard. Result： The nasal obstruction and allergic symptom of 62 patients who underwent radiofrequency ablation were improved in 3 months postoperatively. VAS improved from （89.5±8.7）% to （26.2±8.7）% （left side） and （90.3±10.5）% to（32.1±10.3）%（right side）（ P〈0.01） . In control group ; VAS improved from （90.5 ± 8.0）% to （39.2±8.9） % （left side） and （89. 9±11. 5）% to （48.1±8.1）%0 （right side） （P〈0.01）. However, the mean of postoperative nasal obstruction VAS in radiofrequency ablation group is significantly higher than that in control group（ P〈0.01 ）. Conclusion：Combination application of radiofrequency ablation in nasal operation to cure the inferior turbinates hypertrophic and allergic rhinitis is a safe, effective and less traumatic method.