鼻内镜手术联合低温等离子射频消融术治疗慢性鼻-鼻窦炎效果观察

Effect of Endoscopic Sinus Surgery Combined with Low Temperature Plasma Radiofrequency Ablation in Treatment of Chronic Rhinosinusitis with Nasal Polyps

目的:探讨鼻内镜手术联合低温等离子射频消融术(Low temperature plasma radiofrequency ablation,RFTVR)治疗慢性鼻-鼻窦炎的效果。方法:选取2015年1月-2017年1月本院收治的慢性鼻-鼻窦炎患者98例,按照随机数字表法将其分为观察组和对照组,各49例。对照组行鼻内镜手术,观察组给予鼻内镜手术联合RFTVR治疗。比较两组手术指标,术后1个月、1年的临床疗效,并发症发生情况,手术前后的鼻腔鼻窦结局测试(Sino-Nasal Outcome Test-20,SNOT-20)及术后Lund-Kennedy量表评分。结果:观察组手术时间、住院时间、术中出血量、术后鼻腔渗血量等指标均优于对照组,比较差异均有统计学意义(P<0.05);术后两组SNOT-20评分均低于术前,且术后观察组SNOT-20、Lund-Kennedy评分均显著低于对照组,比较差异均有统计学意义(P<0.05);术后1个月、1年,观察组总有效率为97.96%、95.92%,均高于对照组的81.63%、77.55%,比较差异均有统计学意义(字2=7.127、7.184,P=0.016、0.007);观察组术后并发症发生率为4.08%,显著低于对照组的18.37%,比较差异有统计学意义(P<0.05)。结论:RFTVR具有微创、安全、可重复性等优点,与鼻内镜手术联合治疗慢性鼻-鼻窦炎,在充分发挥鼻内镜手术治疗特点的同时,RFTVR对其又是一个补充,可显著提高临床疗效,减小对患者的创伤,促进患者的康复。

Objective：To investigate the effect of endoscopic sinus surgery combined with low temperature plasma radiofrequency ablation（RFTVR） in treatment of chronic rhinosinusitis with nasal polyps.Method：A total of 98 patients with chronic rhinosinusitis with nasal polyps treated in our hospital from January 2015 to January 2017 were selected.According to the random number table method,they were divided into observation group and control group,49 cases in each group.The control group underwent endoscopic sinus surgery,and observation group was given endoscopic sinus surgery combined with RFTVR.The operative indicators,clinical efficacy after operation 1 month and 1 year,complications,preoperative and postoperative Sino-Nasal Outcome Test-20（SNOT-20） and postoperative Lund-Kennedy scale between two groups were compared.Result：The operative time,hospitalization time,intraoperative blood loss and postoperative nasal bleeding volume in observation group were better than those of control group,the differences were statistically significant（P〈0.05）.After operation,the the scores of SNOT-20 in two groups were all lower than those of before operation,and the scores of SNOT-20 and Lund-Kennedy in observation group were significantly lower than those of control group,the differences were statistically significant（P〈0.05）.After operation 1 month and 1 year,the total effective rate of observation group was 97.96% and 95.92%,which were higher than 81.63% and 77.55% of control group,the differences were statistically significant（x22=7.127,7.184;P=0.016,0.007）.The incidence of postoperative complications in observation group was 4.08%,which was significantly lower than 18.37% of control group,the difference was statistically significant（P〈0.05）.Conclusion：RFTVR is minimally invasive,safe and repeatable,combined with nasal endoscopic surgery for chronic rhinosinusitis with nasal polyps,in full endoscopic surgery characteristics at the same time,RFTVR is also a supplement,it can significantly improve the clinical efficacy,reduce the trauma of patients,promote the rehabilitation of patients.