高强度聚焦超声治疗变应性鼻炎远期疗效的临床研究

Clinical research of long-term efficacy of high intensity focused ultrasound in treating allergic rhinitis

目的观察鼻内窥镜下高强度聚焦超声(HIFU)治疗变应性鼻炎的远期疗效。方法将300例药物治疗无效的变应性鼻炎患者分为治疗组(n=162)及对照组(n=138)。治疗组患者在鼻内窥镜下进行HIFU治疗,对照组患者进行低温等离子消融治疗。两组患者术后随访,采用视觉模拟评分(VAS)于术后3、6、12、24个月进行疗效评定。自愿接受鼻腔纤毛功能检查的两组患者于治疗开始时和治疗结束时行糖精试验,评价其鼻黏膜纤毛功能。结果两组患者治疗2周后鼻塞、喷嚏、流涕、鼻痒等症状均明显缓解,无明显并发症。随访2年治疗组患者的总有效率(61.4%),明显高于对照组(50.7%),差异有统计学意义(P=0.017);治疗组患者(n=49)及对照组患者(n=39)的糖精清除时间平均值分别为(464±152)、(738±149)s,差异有统计学意义(P=0.026)。结论 HIFU治疗变应性鼻炎的远期疗效优于低温等离子消融治疗,并且对鼻黏膜纤毛功能影响更小。

Objective To observe the long-term efficacy of nasal endoscopy-guided high intensity focused ultrasound（HIFU） in the treatment of allergic rhinitis. Methods 300 patients with allergic rhinitis who failed in medication were randomly divided into the treatment group（n= 162） and the control group（n= 138）. The patients in the treatment group were accepted the nasal endosco- py-guided HIFU therapy,while the patients in the control group were subjected to the hypothermy plasma ablation. The two groups were followed up after operation,and the visual analogue scale（VAS） was employed to evaluate the therapeutic efficacy at postoper- ative 3,6,12,24 months. The saccharin tests were performed at the beginning and ending of treatment to assess the nasal mucocili- ary function in the patients of the two groups who voluntarily accepted the functional test of nasal cilia. Results After 2-week treat ment, nasal congestion, sneezing, runny nose, nasal itching and other symptoms in the two groups were significantly relieved with no obvious complication. 2-year follow-up demonstrated that the total effective rate in the treatment group was 61.4G, which was markedly higher than 50.7~ in the control group（P=0. 017）. The average saccharin clearance time of the treatment group（n=49） and the control group（n= 39） were（464±152） s and（738± 149） s, respectively, and their difference was statistical significant（P = 0. 026）. Conclusion The long-term efficacy of HIFU treatment in allergic rhinitis is superior to that of hypothermy plasma abla- tion,possesses less impacts on the nasal mucociliary function,and is worthy of clinical promotion.