鼻内镜下两种不同方法治疗变应性鼻炎的疗效对比

Comparison of curative effect between two nasal endoscopic methods on allergic rhinitis

目的探讨鼻内镜下微波与低温等离子射频消融治疗变应性鼻炎(AR)的疗效。方法鼻内镜下微波治疗AR患者38例为微波组,低温等离子射频消融治疗AR患者46例为射频组。比较两组患者术后并发症、症状评分及术后复发情况。结果两组患者术后1 w～12个月症状评分较术前均显著下降(P<0.01),两组相比,术后3个月内症状评分无显著差异(P>0.05);术后第6及12个月,微波组症状评分高于射频组(P<0.05)。微波组手术时间(6.8±2.4)min显著短于射频组(12.6±4.3)min(P<0.05)。两组各种并发症发生率无显著差异(P>0.05)。微波组术后12个月内复发率为10.5%,射频组无复发,两组有显著差异(χ2=5.084,P<0.05)。结论内镜下微波或射频消融均是治疗AR安全有效的方法,两者各有其优势,射频消融治疗具有更佳的远期疗效及更低的复发率,而微波治疗操作更简便省时。

Objective To discuss the therapeutic effects of nasal endoscopic microwave and hypothermic plasma radiofrequency ablation on allergic rhinitis （AR）. Methods The thirty eight patients with AR who accepted the treatment by microwave under nasal endoscope were considered as microwave group, and 46 patients with AR who accepted the treatment by hypothermic plasma radiofrequency ablation under nasal endoscope were regarded as radiofrequency group. Comparison was made in postoperative complications, symptom score, and postoperative recurrence between the two groups. Results The symptom scores of the two groups decreased significantly 1 week to 12 months after the operation （ P 〈 0. 01 ）. Within 3 months after the operation, there was no significant difference in the symptom scores between the two groups （ P 〉 0.05 ）. In the 6 and 12 month after the operation, that score of the microwave group was higher than that of the radiofrequency group （ P 〈 0. 05 ）. The operative time of the microwave group （ 6.8 ±2.4 ） min was significantly shorter than that of the radiofrequency group （ 12.6 ±4.3 ） min （ P 〈 0.05 ）. There was no significant difference in the incidence of complications between the two groups （ P 〉 0. 05 ）. Within 12 months after the operation, the recurrence rate of the microwave group was 10.5%, but the radiofrequency group had no recurrence, and there was significant difference between the two groups（χ^2 = 5. 084, P 〈 0.05 ）. Conclusion Both the microwave and hypothermic plasma radiofrequency ablation under nasal endoscope are safe and effective methods for AR. The former has the advantage of simple and time - saving operation, while the latter has better long - term curative effects and lower recurrence rate.