经鼻内镜低温等离子系统鼻前庭囊肿揭盖术治疗鼻前庭囊肿患者的疗效评价

Evaluation of the curative effect of transnasal endoscopic low-temperature plasma system uncovering nasal vestibular cyst

目的:研究经鼻内镜(Nasal endoscope,NE)下低温等离子系统鼻前庭囊肿(Nasal vestibular cyst,NVC)揭盖术对NVC患者的临床效果。方法:选取2019年1月至2021年4月我院收治的72例NVC患者作为研究对象进行前瞻性随机平行对照研究,按随机数字表法将其分成观察组和对照组,各36例。对照组接受切割动力系统NVC揭盖术治疗,观察组接受经NE下低温等离子系统NVC揭盖术治疗。对比两组围术期指标、术前、术后1 d炎性因子指标水平、凝血功能指标及并发症发生率。结果:观察组手术时长、住院时长较对照组短,术中失血量较对照组少(P<0.05);术后1d两组血清白细胞介素-8(Interleukin-8,IL-8)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactiveprotein,CRP)水平较术前升高,但观察组较对照组低(P<0.05);术后1 d对照组血浆纤维蛋白原(Fibrinogen,FIB)较术前升高,部分活化凝血活酶时间(Activated partial thromboplastin time,APTT)、血浆凝血酶原时间(Prothrombin time,PT)、凝血酶时间(Thromboplastin time,TT)较术前降低(P<0.05),观察组术后1d Fib、APTT、PT、TT与术前对比,无明显差异(P>0.05),术后1d观察组Fib较对照组低,APTT、PT、TT较对照组高(P<0.05);观察组术后并发症总发生率较对照组低(P<0.05)。结论:经NE下低温等离子系统NVC揭盖术治疗NVC患者可有效优化围术期指标,减轻炎性应激,降低并发症发生风险,且不会对机体凝血功能造成较大影响,安全性高。

Objective:To investigate the clinical effect of Nasal vestibular cyst(NVC)uncovering with low temperature plasma under Nasal endoscope(NE).Methods:Seventy-two patients with NVC admitted to our hospital from January 2019 to April 2021 were selected as subjects for a prospective randomized parallel control study.They were divided into observation group and control group according to random number table method,with 36 cases in each group.The control group was treated with cutting power system NVC uncovering,and the observation group was treated with low temperature plasma system NVC uncovering under NE.The perioperative indicators,the levels of inflammatory factors before and 1 day after surgery,the coagulation function indicators and the incidence of complications were compared between the two groups.Results:The duration of operation and hospitalization in observation group were shorter than those in control group,and the intraoperative blood loss was less than that in control group(P<0.05).The levels of interleukin-8(IL-8),Tumor necrosis factor-α(TNF-α),and C-reactive protein(CRP)in the two groups were higher than those before surgery.But the observation group was lower than the control group(P<0.05).One day after surgery,the plasma Fibrinogen(FIB)of the control group was higher than that before surgery,and the partial Activated partial thromboplastin time(APTT)and Prothrombin time were higher than that before surgery.There were no significant differences in Fib,APTT,PT and TT between the observation group and the control group 1d after operation(P>0.05).Fib of the observation group was lower than that of the control group 1d after operation,and APTT,PT and TT were higher than that of the control group(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05).Conclusion:NVC uncovering with low temperature plasma system under NE can effectively optimize perioperative indicators,reduce inflammatory stress,reduce the risk of complications,and have no significant impact on the body's coagulation function,with high safety.