鼻内镜鼻窦手术联合低温等离子下鼻甲射频消融术治疗慢性鼻-鼻窦炎临床效果分析

Clinical efficacy analysis of endoscopic sinus surgery combined with low-temperature plasma radiofrequency ablation of inferior turbinate in the treatment of chronic rhino-sinusitis

目的探讨鼻内镜鼻窦手术联合低温等离子下鼻甲射频消融术治疗慢性鼻-鼻窦炎的临床效果。方法 90例慢性鼻-鼻窦炎患者,根据手术方法不同分为对照组和观察组,每组45例。对照组患者行鼻内镜鼻窦手术联合下鼻甲骨折外移术治疗,观察组患者行鼻内镜鼻窦手术联合低温等离子下鼻甲射频消融术治疗。比较两组患者治疗效果、术后住院时间、并发症发生情况及手术前后患者鼻阻力、鼻腔鼻窦结局测试-20(SNOT-20)评分、Lund-Kennedy评分。结果观察组患者治疗总有效率为100.00%,高于对照组的77.78%,差异具有统计学意义(P<0.05)。手术前,两组患者鼻阻力、SNOT-20评分、Lund-Kennedy评分比较差异无统计学意义(P>0.05);手术后,观察组鼻阻力、SNOT-20评分、Lund-Kennedy评分分别为(0.24±0.11)kPa/(L·s)、(7.15±1.16)分、(1.21±0.02)分,均优于对照组的(0.42±0.12)kPa/(L·s)、(13.13±2.28)分、(1.91±0.24)分,差异具有统计学意义(P<0.05)。观察组术后住院时间为(4.02±0.12)d,短于对照组的(6.14±0.24)d,差异具有统计学意义(P<0.05)。观察组患者并发症发生率为8.89%,低于对照组的24.44%,差异具有统计学意义(P<0.05)。结论慢性鼻-鼻窦炎患者行鼻内镜鼻窦手术联合低温等离子下鼻甲射频消融术的治疗效果确切,可有效改善病变,降低鼻阻力,改善鼻通气功能,减少并发症,加速康复。

Objective To investigate the clinical effect of endoscopic sinus surgery combined with low-temperature plasma radiofrequency ablation of inferior turbinate in the treatment of chronic rhino-sinusitis. Methods A total of 90 patients with chronic rhino-sinusitis were divided into control group and observation group according to the different surgical methods, 45 cases in each group. Patients in the control group received endoscopic sinus surgery combined with inferior turbinectomy, patients in the observation group receivedendoscopic sinus surgery combined with low-temperature plasma radiofrequency ablation of inferior turbinate. The therapeutic effect, postoperative length of stay and occurrence of complications, the nasal resistance of patients, sino-nasal outcome test-20（SNOT-20） score, Lund-Kennedy score before and after surgery between the two groups were compared. Results The total effective rate of the observation group was 100.00%, which was significantly higher than 77.78% of the control group, the difference was statistically significant（P0.05）. There were no significant differences in the nasal resistance, SNOT-20 score and Lund-Kennedy score between the two groups before surgery（P0.05）. After surgery, the nasal resistance, SNOT-20 score and Lund-Kennedy score in the observation group were（0.24±0.11） kPa/（L·s）,（7.15±1.16） scores and（1.21±0.02） scores respectively, which were significantly better than（0.42±0.12） kPa/（L·s）,（13.13±2.28） scores and（1.91±0.24） scores in the control group, the differences were statistically significant（P0.05）. The postoperative length of stay in the observation group was（4.02±0.12） d, which was significantly shorter than（6.14±0.24） d in the control group, the difference was statistically significant（P0.05）. The incidence of complications in the observation group was 8.89%, which was significantly lower than 24.44% in the control group, the difference was statistically significant（P0.05）. Conclusion The treatment effect of endoscopic sinus surgery combined with low-temperature plasma radiofrequency ablation of inferior turbinate for chronic rhino-sinusitis is reliable, it can effectively improve the lesion, reduce nasal resistance, improve nasal ventilation function, reduce complications and accelerate rehabilitation.