下鼻甲去骨及黏膜划痕微创减容术治疗肥厚性鼻炎的临床研究

Clinical Study of the Minimally Invasive Submucosal Reduction of Lower Turbinates and Mucosal Scratches on the Treatment of Hypertrophic Rhinitis

目的研究下鼻甲去骨及黏膜划痕微创减容术治疗肥厚性鼻炎的临床效果。方法选取2013年1月至2016年6月我院耳鼻咽喉科收治的肥厚性鼻炎患者120例,随机分成两组,试验组60例,行下鼻甲去骨及黏膜划痕微创减容术治疗,对照组60例,行下鼻甲部分切除术治疗,对比两组患者术后临床效果,进行糖精试验,对比术后6个月鼻腔黏膜纤毛功能。结果术后6月,试验组有效率为100%,对照组有效率为98.33%,差异无统计学意义(P>0.05);两组糖精清除时间(saccharin clearance time,SCT)、鼻黏膜纤毛输送率(mucociliary transport rate,MTR)及双侧鼻腔中最小横截面积(minimal cross-sectional area,MCA)均较术前明显改善,且实验组明显优于对照组(P<0.05);试验组手术时间明显比对照组长(P<0.05),但手术中出血量、术后渗血时间、创面愈合时间及并发症发生率明显低于对照组(P<0.05)。结论下鼻甲去骨及黏膜划痕微创减容术对鼻腔黏膜损伤小,能有效改善鼻腔通气功能,且具有并发症少、术后恢复快、手术损伤小等优点,值得临床推广。

Objective To study the clinical effect of minimally invasive submucosal reduction of lower turbinates and mucosal scratches on the treatment of hypertrophic rhinitis. Methods 120 cases with hypertrophic rhinitis were enrolled in this study. From January 2013 to June 2016, 120 patients with hypertrophic rhinitis were randomly divided into two groups. The experimental group （60 cases） underwent lower turbinate osteotomy and mucosal scratches. The control group （60 cases） underwent partial inferior turbinectomy. The clinical results, complication rates, the saccharin test and nasal mucosal cilia functions were compared 6 months after operation. Results The effective rate was 100% in the experimental group and 98.33% in the control group, and the difference was not statistically significant （P 〉 0.05）. The saccharin clearance time （SCT）, mucociliary transport rate （MTR） and minimal cross-sectional area （MCA） of the experimental group were significantly improved, comparing with the control group （P 〈 0.05 ）. The operative time of the experimental group was longer than the control group（P 〈 0.05 ）. However, the intraoperative hemorrhage, postoperative bleeding time, wound healing time and the complication rate were significantly less in the experimental group（P 〈 0.05）. Conclusion It is effective in improving nasal obstruction and related nasal symptoms of the minimally invasive submucosal reduction of lower tnrbinates and mucosal scratches. It has the advantages of less complication, quick postoperative recovery and less surgical injury. It is worthy of popularization.