鼻内镜下聚焦超声治疗变应性鼻炎的临床应用

Focused ultrasound under nasal endoscopy in treatment of perennial allergic rhinitis

目的比较聚焦超声与药物治疗常年变应性鼻炎(perennial allergic rhinitis,PAR)的临床疗效。方法 284例PAR患者随机分组:CZB型聚焦超声治疗(聚焦超声治疗组)140例、常规药物治疗(对照组)144例。于治疗后1、6、12个月进行病情随访,用记分法分别评定其疗效。于聚焦超声治疗前,治疗后1、6、12个月用鼻内镜采集图像作对比观察。结果聚焦超声治疗组与对照组鼻痒、喷嚏、清水样鼻涕等症状明显缓解,聚焦超声治疗组术后无鼻腔粘连及鼻中隔穿孔等。聚焦超声治疗组治疗前及治疗后12个月评分分别为(11.15±2.54)分和(4.68±1.25)分(P<0.01);对照组治疗前及治疗后12个月评分分别为(12.09±2.11)分和(7.12±1.31)分(P<0.01)。治疗后随访有效率分别为:1个月聚焦超声治疗组为97.1%,对照组为94.4%(P>0.05),6个月聚焦超声治疗组为90.7%,对照组为85.4%(P<0.01),12个月聚焦超声治聚焦超声疗组为80.7%,对照组为61.1%(P<0.01)。结论鼻内镜下聚焦超声治疗PAR微创、安全性高、疗效确实可靠。

Objective To compare the therapeutic effects between drugs and focused ultrasound in treatment of perennial allergic rhinitis （PAR）. Methods A total of 284 cases of identified PAR who treated in our hospital during March 2009 to March 2011 were randomized divided into 2 matched groups, test group （n =140） and control group （n = 144）. Those of test group were treated by a CZB ultrasound therapeutic system [ developed and produced by Chongqing Haifu （HIFU） Technology Co. Ltd. ] to scan inferior nasal concha and the anterosuperior part of nasal septum under nasal endoscopy. While those of control group received a conventional drug treatment. The therapeutic effect were evaluated by clinical symptoms controlled counting- scores. Nasal endoscopic images were collected and comparatively observed before and at 1,6 and 12 months after the therapy of focus ultrasound. Results The symptom of nasal itching, rhinorrhea and sneezing in the test group was obviously relieved, while no nasoseptal perforation or nasal adhesion was found. The counting-scores was 11.15 ± 2.54 before treatment and 4.68 ± 1.25 after treatment in 1 year after the treatment in test group （ P 〈 0.01 ）. That was 12.09 ±2.11 before treatment and 7.12 ± 1.31 in 1 year after treatment in the control group （P 〈 0.01 ）. The follow-up data indicated the efficient rate in 1 month was 97.1% in test group, and 94.4% in control group （ P 〈 0.01 ）, in 6 months was 90.7% and 85.4% respectively （ P 〈 0. 01）, and in 1 year was 80.7% and 61.1% respectively （P〈0.01）. Conclusion The treatment of focus ultrasound in PAR is minimally invasive and safe with reliable efficacy.