鼻内镜手术治疗成人变应性鼻炎伴嗅觉减退的临床研究

Effect of nasal endoscopic surgery on allergic rhinitis combined with hyposmia in adult patients

目的探讨鼻内镜手术治疗成人变应性鼻炎伴有上鼻道窦口复合区病变的嗅觉减退的疗效。方法对35例变应性鼻炎伴嗅觉减退患者进行鼻内镜手术,开放上鼻道窦口复合区并彻底清除病变。术后门诊定期鼻内镜复查,比较分析术前及术后1月、3月、12月的T&T嗅觉识别阈平均值和治疗有效率。结果术后1月、3月和12月平均T&T嗅觉识别阈值明显低于术前,差异均有统计学意义(t分别=19.07、17.26、13.32,P均<0.05);术后3月T&T嗅觉识别阈值高于术后1月,术后12月T&T嗅觉识别阈值高于术后3月,差异均有统计学意义(t分别=7.11、5.98,P均<0.05)。患者术后1月、3月、12月治疗有效率分别为:97.14%、94.29%、80.00%,术后1月治疗有效率明显高于术后12月(χ2=5.08,P<0.05)。结论鼻内镜手术治疗变应性鼻炎伴有上鼻道窦口复合区病变的嗅觉减退的短期疗效明显,长期效果需待进一步观察。

Objective To observe the effect of nasal endoscopic surgery on allergic rhinitis combined with hyposmia caused by lesions in superior meatus complex area in adult patients. Methods Totally 35 cases with allergic rhinitis combined with hyposmia underwent endoscopic sinus surgery. The upper nasal meatus ostium complex was opened and the lesions were completely removed. The patients had regular nasal endoscopy after operation. The average T＆T olfactory recognition thresholds and treatment efficiency were compared and analyzed before surgery and 1 month,3 months,and 12 months after surgery. Results The average T＆T olfactory recognition threshold at 1 month,3 months,and 12 months after surgery were significantly lower than before the surgery（t=19.07,17.26,13.32,P〈0.05）. T＆T olfactory recognition threshold was higher at 3 months after operation than at 1 month after operation,and at 12 months after operation,T＆T olfactory recognition threshold was higher than at 3 months after operation（t=7.11,5.98,P〈0.05）.The effective percentages at 1 month,3 months and 12 months after surgery were 97.14%,94.29% and 80.00% respectively. The effective rate at 1 month after surgery was significantly higher than at 12 months after surgery（χ2=5.08,P〈0.05）. Conclusion Nasal endoscopic surgery has obvious short-term effect on allergic rhinitis combined with hyposmia caused by lesions in superior meatus complex area in adult patients,but its long-term effect needs to be further observed.