中下甲部分切除术治疗血管运动性鼻炎

Partial middle and inferior turbinectomy for vasomotor rhinitis

目的 :评价中下甲部分切除术治疗血管运动性鼻炎 (VR)的临床效果。方法 :将 1 2 6例VR患者随机分成 3组 ,每组 42例 ,A组行双侧中下甲黏膜激光烧灼 ;B组行筛前神经和翼管神经电灼术 ;C组行中下甲部分切除术。合并鼻中隔偏曲者同时行鼻中隔黏膜下切除术。术后 1个月、半年、1年和 5年各随访 1次 ,比较 3组术后症状 ,术后并发症和复发率。结果 :3组患者术后症状均消失。但随着随访时间的延长 ,均有部分病例复发。术后 1～ 6个月复发者以A、B两组较多 ,差异无显著性 ,术后 1～ 5年 ,A、B两组复发率达 80 %～ 90 % ,复发后的症状评分与术前相同。而C组术后近期复发率低(术后 6个月为 4 76% ) ,5年后随访复发率为 2 6 1 9% ,复发者症状评分 (5 .1 8± 1 .0 7)明显低于手术前 (8.46± 1 .3 8)。结论 :中下甲部分切除术治疗VR效果好 ,复发率低 ,并发症少 ,且手术操作简单 ,是目前治疗VR的最佳手术方案。

Objective:To evaluate the curative efficacy for partial middle and inferior turbinectomy in treating vasomotor rhinitis(VR). Method:126 cases of VR were randomly divided into 3 groups with 42 patients in each group.Group A were treated with middle and inferior turbinate mucous laser therapy,group B were treated with ethmoidal and vidian nerve cauterigation,group C were treated with partial midddle and inferior turbinectomy.VR complicated with nasal septum deviation were treated with submucous resection of the nasal septum.Result:Clinical symptoms diminished immediately postoperatively in all cases.Five years' follow-up revealed that 80%-90% of cases in group A and B relapsed while only 26.19% cases in group C relapsed (P<0.01) .Conclusion:Partial middle and inferior turbinectomy for VR has advantages of good effect,few relapse and complications.