鼻后神经切断术对高反应性鼻病患者生活质量的影响

Clinical study on resection of the posterior nasal nerve in refractory hyperreactive rhinopathy

目的探讨经鼻内镜鼻后神经切断术对高反应性鼻病患者生活质量的影响。方法选择有手术适应证的高反应性鼻病患者120例,按照2∶1分为2组:A组患者经鼻内镜鼻腔鼻窦手术的同时行双侧鼻后神经切断术;B组患者未行鼻后神经切断术。手术前后分别对患者鼻部症状、生活质量、哮喘控制情况、鼻腔状况及通气功能进行评价。结果 2组患者手术后生活质量各维度均明显改善,差异有统计学意义;而术后12个月以上2组间比较,除RP外其余维度差异均有统计学意义。鼻部症状的总体影响2组患者在术后评分均下降,差异有统计学意义。在术后12个月2组间相比,差异有统计学意义。2组患者术后鼻腔通气功能均明显改善,差异有统计学意义;组间比较术后6个月IER指标差异有统计学意义,到术后12个月以上时,IER和INPR 2个指标差异有统计学意义。结论鼻后神经切断术能明显缓解高反应性鼻病患者鼻部症状,改善鼻腔通气功能,提高患者生活质量。

Objective To investigate the clinical efficacy of endoscopic resection of the posterior nasal nerve （PNN） in treat- ment of refractory hyperreactive rhinopathy. Methods 120 patients with refractory hyperreactive rhinopathy were selected and divided into two groups： endoscopic sinus surgery （ESS） were carried out in all patients, and the resection of PNN were performed simultaneous- ly in 79 patients as group A,the other 41 patients as group B. The evaluation was performed before ESS and at 6 month and 12 month af- ter ESS. And the data of inspiratory effective resistance （IER）, inspiratory nasal rate （INPR）, and nasal minimal cross - sectional area （NMCA） were used to assess the airflow function of nasal cavity. Results The remarkable symptomatic improvement of the general symptom of nose were showed in patients of group A, compared with group B according to VAS more than 12 months after ESS. According to SF- 36 questionnaire,there were significant differences in patients between group A and group B more than 12 months after ESS. A significant difference existed in IER, INPR,and NMCA between the data of the two groups 12 months after ESS. Conclusion The resec- tion of PNN may alleviate the symptoms of patients with refractory hyperreactive rhinopathy, and improve the functional and morphological recovery of the nasal mucosa,and improve the HRQoL.