鼻内镜下双侧翼管神经切断术对变应性鼻炎合并支气管哮喘的临床疗效观察

Curative effect of bilateral endoscopic vidian neurectomy on allergic rhinitis with bronchial asthma

目的评估鼻内镜下双侧翼管神经切断术对变应性鼻炎合并支气管哮喘的临床疗效。方法收集16例变应性鼻炎合并支气管哮喘患者经鼻内镜下双侧翼管神经切断术手术前后的临床资料,应用鼻结膜炎生存质量(RQLQ)、视觉模拟量表(VAS)以及成人哮喘生存质量量表(AQLQ)来评估手术前后患者的生存质量。结果通过对16例病例进行术后随访6个月以上,经统计学分析,术前RQLQ的平均得分为2.23±0.48,VAS的平均得分7.33±1.15;术后6个月RQLQ的平均得分为0.79±0.43,VAS的平均得分为2.51±1.60;术后12个月RQLQ的平均得分为(0.95±0.47),VAS的平均得分为2.62±1.72;术后24个月RQLQ的平均得分为1.35±0.50,VAS的平均得分为2.79±1.73,均低于术前平均得分。AQLQ平均得分术后6个月(4.01±0.60)、12个月(3.85±0.68)及24个月(3.66±0.75)均高于术前(2.91±0.82),差异均具有统计学意义(RQLQ、VAS及AQLQ的P值均<0.01)。结论鼻内镜下双侧翼管神经切断术能有效提高变应性鼻炎合并支气管哮喘患者的生存质量,是一种治疗变应性鼻炎合并支气管哮喘的有效手段。

Objective To evaluate the efficacy of bilateral endoscopic vidian neurectomy on allergic rhinitis with bronchial asthma. Methods 16 patients with allergic rhinitis and bronchial asthma received bilateral endoscopic vidian neurectomy. Rhinoconjunctivitis Quality of Life Questionnaire （RQLQ） , Visual Analogue Scale Questionnaire （ VAS ） and Asthma Quality of Life Questionnaire in Adult （ AQLQ ） were utilized to evaluate the quality of life before and after surgery. Results 16 patients were followed up after surgery. Postoperative scores （x ±s ） of RQLQ and VAS at the time of 6 months （0.79 ±0.43,2.51 ±1.60）, 12 months （0.95 ±0.47,2.62 ±1.71）, 24 months （ 1.35 ± 0.50,2.79 ± 1.73 ） were respectively lower than preoperative scores （ 2.23 ± 0.48,7.33± 1.15）. Postoperative scores （x±s） of AQLQ at the time of 6 months （4.01 ±0.60）, 12 months （3. 85 ± 0.68） , 24 months （3. 66 ± 0. 75） were higher than preoperative scores （2. 91 ± 0. 82）. Their differences between postoperative and preoperative scores were statistically significant （ P 〈 0. 01 ）. Conclusions Bilateral endoscopic vidian neurectomy is an effective and safe technique in the treatment for patients with allergic rhinitis and bronchial asthma, which can effectively improve the quality of life of the patients.