鼻内镜下低温等离子消融术治疗鼻腔血管瘤的临床效果

Clinical effect of low temperature plasma ablation under nasal endoscope in the treatment of nasal hemangioma

目的探讨鼻内镜下低温等离子消融术治疗鼻腔血管瘤的临床效果.方法选择佛山市中医院耳鼻咽喉科2015年1月至2019年1月根据治疗方法不同对照组30例施行鼻内镜下鼻腔血管瘤切除手术;研究组30例施行鼻内镜下低温等离子消融术,比较两组手术时间和术中出血量;采用视觉模拟评分法(VAS)评估术后第1~3天评估术后疼痛评分;检测术后第1~3天血清炎性因子;统计术后并发症发生率,术后恢复时间包括术后鼻腔黏膜上皮化时间和住院时间,采用特殊残疾—鼻腔鼻窦结局测试量表(SNOT-20)评估生活质量评分.结果研究组手术时间和术中出血量均少于对照组;两组第2和第3天术后疼痛评分和血清炎性因子均较第1天下降,研究组治疗第1、2和3天术后疼痛评分和血清炎性因子较对照组降低更为显著,差异有统计学意义(P<0.05).术后仅有对照组4例发生并发症,并发症发生率13.33%.手术后,两组生活质量评分均较手术前降低;研究组的生活质量评分较对照组更低;术后研究组鼻腔黏膜上皮化时间和住院时间均短于对照组;差异有统计学意义(P<0.05).结论鼻内镜下低温等离子消融术可有效减轻鼻腔血管瘤患者的手术创伤,减轻其术后疼痛感和炎性反应,有利于减少术后并发症,加快术后康复,改善生活质量.

Objective To investigate the clinical effect of low temperature plasma ablation under nasal endoscope in the treatment of nasal hemangioma. Method From January 2015 to January 2019, 30 patients in the Otolaryngology Department of Foshan Hospital of Traditional Chinese Medicine were selected as control group to undergo endoscopic resection of nasal hemangioma. In the study group, 30 patients underwent low temperature plasma ablation under nasal endoscope in the treatment of nasal hemangioma and the operation time and intraoperative bleeding volume were compared between the two groups. Visual analogue scale (VAS) was used to evaluate the pain score on the 1st to 3rd day after operation, and the serum inflammatory factors on the 1st to 3rd day after operation were detected.The incidence of postoperative complications and the recovery time included the epithelialization time of nasal mucosa and hospitalization time. The quality of life score was assessed by the Special Disability-Nasal Sinus Outcome Test (SNOT- 20). Result The operation time and intraoperative bleeding volume of the study group were less than those of the control group;the VAS scores and serum inflammatory factors of the two groups on the 2nd and 3rd day after operation were lower than those on the 1st day, and the VAS scores and serum inflammatory factors of the study group on the 1st, 2nd and 3rd day after treatment were more significantly lower than those of the control group (P<0.05).Only 4 cases in the control group had complications, the incidence of complications was 13.33%. After operation, the scores of quality of life in both groups were lower than those before operation;the scores of quality of life in the study group were lower than those in the control group;the epithelialization time and hospitalization time of nasal mucosa in the study group were shorter than those in the control group after operation;the difference was statistically significant (P<0.05). Conclusion Low temperature plasma ablation under nasal endoscope can effectively relieve the surgical trauma of patients with nasal hemangioma, relieve the pain and inflammatory reaction after operation, help to reduce postoperative complications, speed up the recovery after operation and improve the quality of life.