3种手术方案治疗慢性肥厚性鼻炎临床疗效的对比研究

Comparison of clinical effect among three operation schemes in treatment of chronic hypertrophic rhinitis

目的探讨下鼻甲射频消融术、黏膜下部分切除术及下鼻甲射频消融术联合骨折外移术治疗慢性肥厚性鼻炎临床疗效差异。方法选取慢性肥厚性鼻炎患者共300例,随机分为A、B及C组,每组100例。分别采用鼻甲射频消融术、黏膜下部分切除术及下鼻甲射频消融术联合骨折外移术;比较3组患者临床疗效和安全性。结果 B组和C组患者近期疗效、术后白天和夜间鼻通气主观评分,双侧鼻腔最小横截面积(NMCA)、鼻腔容积(NCV)、鼻气道阻力(NAR)及鼻腔最小横截面积到前鼻孔的距离(DCAN)水平等均优于A组及同组术前(P<0.05);3组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论黏膜下部分切除术与下鼻甲射频消融联合骨折外移术治疗慢性肥厚性鼻炎在保留鼻腔黏膜及腺体正常生理功能,缓解鼻部堵塞症状方面效果优于下鼻甲射频消融术。

Objective To investigate the clinical effect of three schemes of inferior turbinate operation including radiofrequency ablation of inferior turbinate, inferior turbinate resection and radiofrequency ablation of inferior turbinate combined with inferior turbinectomy in the treatment of chronic hypertrophic rhinitis.Methods Totally 300 patients with chronic hypertrophic rhinitis were selected from July 2013 to July 2015 in our hospital and randomly divided into three group： group A（100 patients） with radiofrequency ablation of inferior turbinate, group B（100 patients） with inferior turbinate resection and group C（100 patients） with radiofrequency ablation of inferior turbinate combined with inferior turbinectomy. The short-term clinical effect,the nasal ventilation subjective score in the day-and night-time, the levels of NMCA, DCAN, NCV and NAR before and after surgery and the incidence of adverse effects of the three groups were compared.Results The short-term clinical effects（P〈0.05）, the nasal ventilation subjective score in the day-and nighttime（P〈0.05）, the levels of NMCA, DCAN, NCV and NAR（P〈0.05） of the group B and the group C were significantly better than those of group A and the same groups before surgery. There were no significant differences in the incidence of adverse effect among the three groups（P〈0.05）. Conclusions Compared with radiofrequency ablation of inferior turbinate, inferior turbinate resection and radiofrequency ablation of inferior turbinate combined with inferior turbinectomy in the treatment of chronic hypertrophic rhinitis are more efficient in maintaining the function of nasal mucosa and gland and relieving nasal obstruction symptoms.