鼻内镜下鼻中隔成形术加下鼻甲重塑治疗持续性变应性鼻炎

Remodeling of inferior nasal turbinate and septorhinoplasty under nasal endoscopy for perennial allergic rhinitis

目的观察合并鼻中隔偏曲的变应性鼻炎(AR)患者下鼻甲重塑加鼻中隔成形术的疗效。方法对确诊为持续性变应性鼻炎经药物或免疫治疗效果不佳,常规行鼻内镜检查及鼻窦CT扫描后愿意行手术治疗的48例患者,分成2组,对照组行鼻内镜下鼻中隔成形术,实验组行鼻内镜下鼻中隔成形术加双侧下鼻甲重塑,此后3个月、6个月、1年时随访,根据2004年兰州诊断及疗效评定标准进行疗效判定及临床分析。结果在48例合并鼻中隔偏曲的变应性鼻炎患者中,对照组:术后3个月有效率为86.3%(19/22),术后6个月有效率为72.7%(16/22):术后1年有效率为63.6%(14/22);实验组:术后3个月有效率为96.2%(25/26),术后6个月有效率为92.3%(24/26),术后1年有效率为88.5%(23/26)。结论对经过常规药物治疗效果不佳、合并鼻中隔偏曲的持续性变应性患者,鼻内镜下进行下鼻甲重塑加鼻中隔成形术手术可取得更好的效果。

【Objective】 To investigate operation therapeutic effect of inferior nasal concha remodeling and septorhinoplasty on patients with the perennial allergic rhinitis（AR） complic deflection of nasal septum.【Methods】48 patients with allergic rhinitis who receive medication,immunotherapy and get poor effect are enrolled in the study.They are willing to undergo operation after the conventional nasal endoscopy examina-tion and CT scans of accessory nasal cavity and are divide into 2 groups.Control group（CG） are given endo-scope septorhinoplasty.experimental group（EG） are given endoscope septorhinoplasty and inferior nasal concha remodeling.Therapeutic effect assessment and clinical analysis of the patients are done according to the 2004 Lanzhou Diagnostic and Treatment Evaluation Standard in the follow-up visit after 3 mouths,6 mouths and 1 year.【Results】 Of all the 48 patients with the allergic rhinitis（AR） complex deflection of nasal septum,the effective rate is 86.3%（19/22） after 3 mouths of operation,72.7%（16/22） after 6 mouths and 63.6%（14/22） after a year in CG.In EG,the effective rate is 96.2%（25/26） after 3 mouths of operation,92.3%（24/26） af-ter 6 mouths and 88.5%（23/26） after a year.【Conclusions】 The endoscope septorhinoplasty and inferior nasal concha remodeling have better effect on patients with persistence allergic rhinitis（AR） complic deflection of nasal septum who receive conventional medication and get poor therapeutic effect.