改良切口鼻中隔成形术治疗变应性鼻炎的疗效及对患者鼻腔通气及生存质量的影响

Effect of modified incision of nasal septum on allergic rhinitis and its effect on nasal ventilation and quality of life

目的探讨改良切口鼻中隔成形术治疗变应性鼻炎（AR）的疗效及对患者鼻腔通气及生存质量的影响。方法选取变应性鼻炎患者69例，依据手术方案分为两组，对照组34例，研究组35例。研究组行改良切口鼻中隔成形术，对照组予以传统Killian切口单纯鼻中隔黏膜切除术。统计对比两组术中资料（手术用时、术中出血量、术中暴露情况及黏膜完整性）、临床效果、术后并发症发生情况，并对比两组手术前后临床症状视觉模拟评分（VAS）、鼻腔通气功能[鼻阻力（NR）及鼻腔最小截面积（NMCA）]及生存质量评分。结果与对照组相比，研究组手术用时较短，术中出血量较少，术中暴露情况及黏膜完整性较好，差异有统计学意义（P〈0.05）。研究组临床总有效率（94.29%）高于对照组（73.53%），差异有统计学意义（P〈0.05）。术后两组各项症状VAS评分均显著下降，且研究组均低于对照组，差异有统计学意义（P〈0.05）。两组术前NMCA、NR比较差异均未见统计学意义（P〉0.05）；术后，两组NMCA、NR均改善，且研究组NMCA高于对照组，NR低于对照组，差异有统计学意义（P〈0.05）。两组术前生存质量各项评分比较差异均未见统计学意义（P〉0.05）；术后，两组生存质量各项评分均下降，且研究组眼部、鼻部、非鼻眼症状及睡眠障碍评分均低于对照组，差异有统计学意义（P〈0.05）。研究组并发症发生率（11.43%）低于对照组（32.35%），差异有统计学意义（P〈0.05）。结论对AR患者予以改良切口鼻中隔成形术，手术用时短、术中出血少，术中暴露情况及黏膜完整性较好，效果较为显著，可有效缓解患者临床症状及鼻腔通气功能，提高生存质量，且具有一定安全性。

Objective To investigate the effect of modified incision of nasal septum on allergic rhinitis （AR） and its effect on nasal ventilation and the quality of life of patients. Methods Sixty-nine cases of allergic rhinitis were divided into control group （34 cases） and study group （35 cases） according to the surgical procedure. Patients in the study group were treated by modified incision of nasal septum, and patients in the control group were treated by conventional Killian incision. The statistical data （operation time, intraoperative blood loss, intraoperative exposure and mucosal integrity ）, clinical effect, complications after operation of the two groups were compared, and the clinical symptoms of visual analogue scale （VAS） , nasal ventilation function [ nasal resistance （NR） and minimum nasal cross-sectional area （NMCA） ] and quality of life scores between the two groups before and after surgery were compared. Results Compared with the control group, the study group had shorter operation time, less intraoperative blood loss, and better exposure and mucosal integrity, the differences were statistically significant （P 〈0.05）. The clinical total effective rate of the study group （94. 29% ） was higher than that of the control group（73.53% ）, the difference was statistically significant （P 〈 0. 05 ）. The VAS scores of every items in the two groups decreased after operation, and the study group was lower than the control group, the differences were statistically significant （P 〈 0. 05 ）. The preoperative NMCA and NR showed no significant difference between the two groups （ P 〉 0.05 ） ; after operation, NMCA and NR of both groups improved, and NMCA of the study group was higher than that of the control group, NR was lower than that of the control group, the differences were statistically significant （P 〈 0. 05 ）. The preoperative quality of life scores showed no significant difference between the two groups （ P 〉 0. 05 ） ; after operation, quality of life scores of both groups decreased, and the score of eye, nose, non nasoeular symptoms and sleep disorder of the study group were lower than those of the control group, the differences were statistically significant （ P 〈 0.05 ）. The incidence of complications in the study group （ 32.35% ） was lower than that in the control group （ 11.43 % ）, and the difference was statistically significant （ P 〈 0.05 ）. Conclusions The modified incision of nasal septum applied to AR patients has short operation time, less intraoperative blood loss, good intraoperative exposure and mucosal integrity, and obvious effect, which can effectively relieve clinical symptoms and nasal ventilation function of patients, improve the quality of life, and has a certain of safety and important significance in clinical treatment.