鼻内窥镜下手术治疗常年性变应性鼻炎长期疗效的研究

Long-term effect of surgical treatment for perennial allergic rhinitis

目的评价手术治疗常年性变应性鼻炎的长期疗效。方法于鼻内窥镜下行双侧微波热凝切断筛前神经鼻腔外侧支及双下甲部分切除术治疗常年性变应性鼻炎,合并有鼻中隔偏曲、慢性鼻窦炎及鼻息肉等同时行鼻中隔成形术、功能性鼻窦开放及鼻息肉摘除术。并根据是否为单纯常年性变应性鼻炎及是否合并有鼻中隔偏曲或慢性鼻窦炎分为两组。于术后第1年后开始进行随访,后3个月随访一次至术后第3年,并进行两组复发率的比较。结果根据每个病人随访过程中是否有效或无效绘制两组Kaplan-Meier曲线。对数秩检验示两组的复发率无统计学差异(P>0.05)。结论微波热凝切断筛前神经鼻腔外侧支及双下甲部分切除术术式简单,费用少,病人痛苦小,对药物治疗无效的常年性变应性鼻炎患者来说是一个不错的治疗方式。

To evaluate the long-term effect of surgical treatment on perennial allergic rhlnitis （PAR）. Methods The lateral branches of anterior ethmoid nerve were coagulated by microwave and the inferior turbinates were partially removed under nasal endoscope, the PAR associated with deviation of nasal septum or chronic sinusitis were treated by nasal septum reconstruction or functional endoscope sinus surgery at the same time. The patients with PAR were divided into two groups according to associated with deviation of nasal septum or chronic sinusitis or not. The efficacy were eval- uated one year after the operation, then followed up for every three month until three years. The relapse rate was analyzed. ResultsAccording to utility or not, we described the KaplarrMeier curve of the two groups and compared the relapse rate by log-rank test. The value of the two groups has no significant differences. Conclusion The operation is simple, cheap and less painful for patients, so it＇s a good method for the treatment of PAR.