鼻内镜鼻窦手术联合低温等离子下鼻甲射频消融术治疗慢性鼻-鼻窦炎的疗效观察

Clinical observation of functional endoscopic sinus surgery associated with radiofrequency ablation of inferior turbinate for chronic rhinosinusitis

目的:对行鼻内镜鼻窦手术联合低温等离子射频消融术治疗的慢性鼻-鼻窦炎患者术前、术后进行临床观察,探讨鼻内镜鼻窦手术联合低温等离子射频消融术的临床疗效。方法:将54例拟行手术治疗的慢性鼻-鼻窦炎患者随机分为治疗组和对照组。治疗组行鼻内镜鼻窦手术联合低温等离子射频消融术及下鼻甲骨折外移术,在治疗前及治疗后12个月观察并检测其主观症状、黏膜清除时间及鼻阻力、嗅觉、鼻腔形态变化,并与对照组(行鼻内镜鼻窦手术联合下鼻甲骨折外移术)进行对比。结果:术后2组患者鼻塞、头面部胀痛、流脓涕、鼻涕倒流、头痛等症状均明显缓解,治疗组缓解更为明显。术后2组患者的鼻阻力、SNOT-20评分及黏膜清除功能均较术前改善,差异有统计学意义(P<0.05)。术后12个月治疗组和对照组SNOT-20评分分别为(7.05±3.77)分和(13.58±3.91)分,Lund-Kennedy评分分别为(1.24±0.91)分和(1.83±0.67)分,鼻阻力分别为(0.36±0.11)kPa/(L·s-1)和(0.42±0.12)kPa/(L·s-1);治疗组均较对照组改善明显,差异有统计学意义(P<0.05)。术后2组间黏膜清除时间比较差异无统计学意义(P>0.05)。结论:鼻内镜鼻窦手术联合低温等离子射频消融术是治疗慢性鼻-鼻窦炎的一项安全有效的新技术。

Objective：To explore the clinical efficacy of functional endoscopic sinus surgery（FESS） associated with radiofrequency ablation on chronic sinusitis. Method：Fifty-four patients with chronic sinusitis were divided randomly into two groups：the study group and the control group,The study group received FESS associated with inferior turbinate lateral fracture and radiofrequency ablation treatment,while the control group received FESS as- sociated with inferior turbinate lateral fracture treatment. Result：The SNOT-20 score, Lund-Kennedy score, mu- cociliary clearance timeand nasal airway resistance of the patients in the two groups after treatment were signifi- cantly improved than those before treatment （P〈0.05）, and the sense of nasal congestion, headache and face pain, purulent rhinorrhea,postnasal drip,and other symptoms were also relieved. After treatment,the scores of SNOT- 20 and the scores of Lund-Kennedy in the study group were significantly lower than those in the control group （P〈0.05） ,but no significant difference was found in mucociliary clearance time between the two groups after treatment. Conclusion： FESS associated with radiofrequeney ablation surgery is safe and effective for chronic sinusitis.