经鼻内镜下鼻甲去骨及黏膜划痕微创减容术治疗慢性肥厚性鼻炎临床疗效观察

The Observation on Clinical Effect of Surgical Method to Cure Chronic Hypertrophic Rhinitis by Endoscopic Sinus Inferior Turbinate Boning and Mucosa Scratches Minimally Invasive Volume Reduction Surgery

目的:探讨慢性肥厚性鼻炎的治疗中经鼻内镜下鼻甲去骨及黏膜划痕微创减容术的临床效果。方法:在临床上已确诊为慢性肥厚性鼻炎患者90例,随机数字表法分成两组,试验组45例行下鼻甲去骨及黏膜划痕微创减容术治疗,对照组45例行下鼻甲部分切除术治疗,术后观察及分析6个月临床效果、术后并发症,以及使用糖精试验对比术后3、6个月鼻腔黏膜纤毛功能。结果:两组临床疗效比较,差异无统计学意义(P>0.05)。试验组手术并发症发生率明显低于对照组,比较差异有统计学意义(P<0.05)。试验组术后3、6个月鼻黏膜纤毛输送率(mucociliary transport rat,MTR)分别与术前比较,差异无统计学意义(P>0.05);而对照组分别较术前明显降低(P<0.01),且与试验组相比均降低(P<0.01)。结论:经鼻内镜下鼻甲去骨及黏膜划痕微创减容术疗效确切、并发症少,且术后能保留了鼻黏膜功能,符合临床生理功能,值得推荐。

Objective： To discuss the clinical effect of endoscopic sinus inferior turbinate boning and mucosa scratches minimally invasive volume reduction surgery to cure chronic hypertrophic rhinitis. Method： 90 patients with the clinical diagnosis of chronic hypertrophic rhinitis were randomly divided into two groups ： the experiment group contained 45 cases accepted the inferior turbinate boning and mucosa scratches minimally invasive volume reduction surgery; the control group contained 45 cases accepted the operation of partial inferior turbinectomy. For a comparative analysis, they were observed for 6 months for clinical results and postoperative complications after operation. Then the saccharin test was carried out. The nasal mucociliary function at 3 months after operation and 6 months after operation was compared. Result： The difference of the clinical effect between the two groups was not statistically significant （ P〉0.05 ） ; the occurrence rate of operative complication of the experiment group was significantly lower than that of the control group （ P〈0.05 ） ; the mucociliary transport rate （ MTR ） of the experiment group, before the operation and 3 months after operation and 6 months after operation, had no obviously changes （P〉0.05）, but that of the control group was obviously lower than pre-operation （ on average, P〈0.01 ） . The MTR of the control group was lower than that of the experiment group at 3 months after operation and 6 months after operation （ P〈0.01 ） . Conclusion： Endoscopic sinus inferior turbinate boning and mucosa scratches minimally invasive volume reduction surgery is effective. It has fewer complications, which keeps the function of nasal mucosa and is consistent with clinical physiological function, so it is recommended.