下鼻甲序贯手术在慢性肥厚性鼻炎中的应用

Application of inferior nasal concha sequential surgery in the treatment of chronic hypertrophic rhinitis

目的探讨下鼻甲序贯手术治疗慢性肥厚性鼻炎患者的应用价值,为临床提供一种优化的下鼻甲手术方案。方法随机纳入的109例肥厚性鼻炎患者,随机分为2组:序贯手术组54例、单纯等离子治疗组55例。分別于治疗后第2周、第2个月、第6个月记录患者的鼻塞、闷胀、鼻痒、流涕、鼻腔干燥、疼痛、鼻不适感的病情严重程度视觉模拟量表(VAS)积分及Lund-Kennedy内镜评分标准积分,观察治疗6个月。结果序贯手术组、单纯等离子治疗2个月、6个月后,2组的Lund-Kennedy内镜评分无统计学意义(P>0.05);2组在治疗第2周后Lund-Kennedy内镜评分的积分有统计学意义(P<0.05);序贯手术组Lund-Kennedy内镜评分的积分低于单纯等离子治疗组。2组在病情严重程度视觉模拟量表鼻塞、闷胀、鼻痒、流涕积分疗效的比较上存在统计学意义(P<0.05);2组在病情严重程度视觉模拟量表鼻腔干燥、疼痛、鼻不适感积分疗效的比较上存在统计学意义(P<0.05),序贯手术组鼻塞模拟视觉量表的积分低于单纯等离子治疗组。结论序贯手术组、单纯等离子治疗组在治疗肥厚性鼻炎上均取得了满意的疗效。2组患者经客观的Lund-Kennedy内镜评价,疗效无统计学意义。经主观视觉模拟量表评价,序贯手术组均优于单纯等离子治疗组。下鼻甲序贯手术对慢性肥厚性鼻炎有良好的疗效,对于保护下鼻甲生理功能、避免术后患者主观不适有明显的优越性。

Objective To explore the application value of inferior nasal concha sequential surgery in the treatment of chronic hypertrophic rhinitis,so as to provide a optimized inferior nasal concha surgical protocol for clinical treatment.Methods A total of 109 patients with hypertrophic rhinitis were randomly enrolled and divided into sequential surgery group（ n = 54） and single plasma treatment group（ n = 55）. The severity degree of rhinobyon,nasal stuffy,rhinocnesmus,mycteroxerosis,nasal pain,and nasal discomfort,visual analogue scale（ VAS） score and Lund-Kennedy endoscope scores were recorded 2 weeks,2 months and 6 months after the treatment. Results There was no significant difference between two groups in Lund-Kennedy endoscope score after treatment for 2 and 6 months respectively（ P〉0. 05）,but the difference was significant after 2-week treatment（ P〈0. 05）. Sequential surgery group was markedly lower in the total Lund-Kennedy endoscope score than single plasma treatment group. There were significant differences between the two groups in the severity scores of VAS like rhinobyon,nasal stuffy,rhinocnesmus and running nose（ P〈0. 05）,and the differences in the severity scores of VAS like mycteroxerosis,nasal pain,and nasal discomfort were also significant（ P〈0. 05）. Sequential surgery group was markedly lower in the total VAS score than single plasma treatment group. Conclusion Both groups have obtained satisfactory efficacy in the treatment of hypertrophic rhinitis. There is no significant difference between the two groups in objective Lund-Kennedy endoscope evaluation score.According to subjective VAS evaluation,sequential surgery group is evidently better than single plasma treatment group in clinical efficacy. Inferior nasal concha sequential surgery has excellent clinical efficacy in the treatment of chronic hypertrophic rhinitis,and also has significant advantages in protecting the physical function of inferior nasal concha and avoiding patients＇ postoperative subjective discomfort.