等离子低温射频消融术联合鼻内镜对慢性鼻窦炎患者嗅觉功能及血清炎症介质的影响

The Effect of Plasma Low-temperature Radiofrequency Ablation Combined with Nasal Endoscopy on Olfactory Function and Serum Inflammatory Mediators in Patients with Chronic Sinusitis

目的:探讨等离子低温射频消融术联合鼻内镜对慢性鼻窦炎(CRS)患者嗅觉功能及血清炎症介质的影响。方法:选取2016年3月~2018年7月期间我院收治的CRS患者127例,根据手术方式的不同将患者分为A组(n=62,鼻内镜手术)和B组(n=65,等离子低温射频消融术联合鼻内镜手术),术后随访1年,比较两组患者临床疗效、症状评分、嗅觉功能、血清炎症介质及并发症情况。结果:B组术后1年的临床总有效率为87.69%(57/65),高于A组的72.58%(45/62)(P<0.05);术后3个月B组的嗅觉功能分布优于A组(P<0.05);两组患者术后3个月鼻塞、头面部胀痛、流脓涕、鼻涕倒流、头痛等症状评分均降低,且B组低于A组(P<0.05)。两组患者术后1周血清白介素-5(IL-5)、白介素-17(IL-17)以及肿瘤坏死因子-α(TNF-α)均降低,且B组低于A组(P<0.05)。两组术后并发症发生率比较无差异(P<0.05)。结论:CRS在鼻内镜的基础上联合等离子低温射频消融术治疗的疗效显著,能够有效改善患者嗅觉功能和临床症状,抑制机体炎性反应的同时不增加并发症发生率。

Objective:To investigate the effect of plasma low-temperature radiofrequency ablation combined with nasal endoscopy on olfactory function and serum inflammatory mediators in patients with chronic sinusitis(CRS).Methods:127 patients with CRS who were admitted to our hospital from March 2016 to July 2018 were selected,they were divided into group A(n=62,endoscopic surgery)and group B(n=65,plasma low-temperature hypothermia radiofrequency ablation combined with endoscopic surgery)according to different surgical methods.Postoperative follow-up was 1 year.The clinical efficacy,symptom score,olfactory function,serum inflammatory mediators and complications of the two groups were compared.Results:The total clinical effective rate of group B at 1 year after surgery was 87.69%(57/65),which was higher than that of group A 72.58%(45/62)(P<0.05).The distribution of olfactory function in group B was better than that in group A 3 months after operation(P<0.05).The scores of nasal congestion,head and facial distemper,runny nose,nasal reflux,headache and other symptoms in the two groups at 3 months after operation were all decreased,and those in group B were lower than those in group A(P<0.05).The serum levels of interleukin-5(IL-5),interleukin-17(IL-17)and tumor necrosis factor-α(TNF-α)in the two groups at 1 weeks after operation were decreased,and those in group B were lower than those in group A(P<0.05).There was no difference in the incidence of postoperative complications between the two groups(P<0.05).Conclusion:On the basis of nasal endoscopic therapy,CRS combined with plasma low-temperature radiofrequency ablation has a significant effect,which can effectively improve the olfactory function and clinical symptoms of patients,inhibit the inflammatory response of the body without increasing the incidence of complications.