鼻内镜鼻窦手术联合鼻甲射频消融术治疗慢性鼻窦炎的临床观察

Endoscopic sinus surgery and radiofrequency ablation of turbinate in the treatment of chronic sinusitis

目的观察鼻内镜下鼻窦手术联合鼻甲射频消融术治疗慢性鼻窦炎的临床效果。方法选取晋中市中医院2017年1月至2018年1月诊治的86例慢性鼻窦炎患者为研究对象,按随机数字表法分为观察组和对照组,每组43例。观察组采用鼻内镜下鼻窦手术与鼻甲射频消融手术联合治疗,对照组单独应用鼻内镜下鼻窦手术进行治疗。对比两组患者的一般手术指标、手术治疗效果以及并发症发生情况。结果两组患者术中出血量比较差异未见统计学意义(P>0.05);观察组手术用时长于对照组,而术后鼻腔渗血量、住院时间以及视觉模拟疼痛评分(VAS)均短/少于对照组(P<0.05);观察组手术治疗总有效率为97.67%,高于对照组的86.05%(P<0.05);观察组患者术后鼻腔粘连、鼻腔黏膜水肿以及窦口狭窄等并发症发生率低于对照组(P<0.05)。结论对慢性鼻窦炎患者采用鼻内镜下鼻窦手术联合鼻甲射频消融术治疗可取得满意效果,有助于降低患者术后并发症的发生率并缓解术后疼痛,提升临床疗效,值得临床推广应用。

Objective To observe the clinical effect of combined endoscopic sinus surgery and turbinate radiofrequency ablation on chronic sinusitis. Methods Eighty-six patients with chronic sinusitis diagnosed and treated in Jinzhong Hospital of Traditional Chinese Medicine from January 2017 to January 2018 were selected as subjects. And the patients were divided into observation group and control group, according to the method of random number table, with 43 cases in each group. Patients in the observation group were treated by endoscopic sinus surgery and radiofrequency ablation of the turbinate. Patients in the control group were treated by endoscopic sinus surgery. The general surgical index, surgical treatment effect and complications were compared between the two groups. Results There was no significant difference in the mean bleeding volume between the two groups (P>0.05). The operation time of the observation group was longer than that of the control group, however, the postoperative nasal oozing volume, hospital stay and visual analogue scale (VAS) score of the observation group were less than those of the control group (P<0.05). The total effective rate of surgical treatment in the observation group was 97.67%, higher than the 86.05% of the control group (P<0.05). Compared with control group, the observation group had lower incidence of complications, such as nasal adhesion, nasal mucosal edema and sinus stenosis (P<0.05). Conclusions Endoscopic sinus surgery combined with radiofrequency ablation of the turbinate can achieve ideal outcome in the treatment of chronic sinusitis, which can help reduce the postoperative complication rate, relieve pain, and improve therapeutic effects, which is worthy of clinical application promotion.