鼻内镜下肥大下鼻甲射频消融术的疗效观察

Curative Effect of Radiofrequency Ablation for Inferior Turbinate Hypertrophy under Nasal Endoscopy

目的评价鼻内镜下肥大下鼻甲射频消融术的疗效。方法对30例因肥大下鼻甲导致鼻塞的患者,在鼻内镜下行下鼻甲双极射频消融术,术后常规用生理盐水冲洗鼻腔和鼻用激素喷鼻,每天1次。比较手术前与手术后1月、3月,观察者对患者症状、体征的评分和患者对疾病总体严重程度评价的评分,并计算"积分下降指数"和"上升阶梯数",以此评价疗效。结果手术后1月、3月,观察者对患者症状、体征的评分和患者对疾病总体严重程度评价的评分都下降,与手术前相比,差异有显著性意义(P<0.05)。依"积分下降指数":手术后1月,显效70.0%、良效23.3%、微效6.7%;手术后3月,显效76.6%、良效16.7%、微效6.7%。依"上升阶梯数":手术后1月,显效73.3%、良效16.7%、微效10.0%;手术后3月,显效76.7%、良效13.3%、微效10.0%。根据"积分下降指数"和"上升阶梯数"对疗效的评价具有一致性。结论鼻内镜下鼻甲射频消融术是一种微创、疗效确切、方便的治疗方法,下鼻甲的黏膜肥厚是该法的最佳适应证。

Objective To assess the curative effect of bipolar radiofrequency ablation for the inferior turbinate in patients with inferior turbinate hypertrophy under nasal endoscopy. Methods Thirty cases of nasal obstruction caused by turbinate hypertrophy were subjected to bipolar radiofrequency ablation for the inferior turbinate under nasal endoscopy, and postoperatively saline irrigation and topical steroid spraying of nasal cavity were routinely carried out, once every day. Before and on the postoperative month 1 and 3, the outcomes were evaluated using a self-designed scale. The score of dropping index and impro- ving scale were calculated. Results The scores were significantly decreased at first and 3rd month postoperation as compared with those before operation （P〈0.05）. The score of dropping index indicated 70.0% of the patients achieved final relief, 23.3% obvious relief at first month after operation, and at 3rd month after operation, 76.6% of the patients achieved final relief and 16.7% obvious relief respectively. Improving scale showed 73.3% of the patients achieved final relief and 16.7 % obvious relief at first month after operation, and at 3rd month after operation, 76. 7% of the patients achieved final relief and 13.3% obvious relief respectively. Conclusion Bipolar radiofrequency ablation for the inferior turbinate under nasal endoscopy is an effective, minimally invasive and convenient alternative for the treatment of patients with nasal obstruction due to inferior turbinate hypertrophy. The mucosal hypertrophy of turbinate is of the best indication.