鼻内镜下PNN切断术治疗难治性变应性鼻炎疗效观察

Efficacy of the resection of posterior nasal nerve with low-temperature plasma knife under nasal endoscope in treatment of refractory allergic rhinitis

目的观察鼻内镜下低温等离子刀鼻后神经(PNN)切断术治疗难治性变应性鼻炎的临床疗效。方法选择2017年3月至2020年4月于陕西中医药大学第二附属医院耳鼻喉科就诊的90例难治性变应性鼻炎患者为研究对象,根据随机数表法分为观察组和对照组各45例,对照组患者采用药物保守治疗,观察组患者采用鼻内镜下PNN切断术治疗,比较两组患者治疗1个月后的疗效和视觉模拟量表(VAS)评分,以及治疗6个月后、1年后的鼻炎相关生活质量量表(RQLQ)评分。结果观察组患者的治疗总有效率为95.56%,明显高于对照组的77.78%,差异有统计学意义(P<0.05);治疗前,两组患者的各项症状VAS评分比较差异均无统计学意义(P>0.05);治疗后,两组患者的各项症状VAS评分明显低于治疗前,且观察组患者治疗后的鼻塞、鼻痒、流涕、喷嚏评分分别为(2.56±0.32)分、(2.28±0.11)分、(2.62±0.31)分、(1.53±0.55)分,明显低于对照组的(2.98±0.54)分、(2.91±0.14)分、(2.91±0.46)分、(1.87±0.62)分,差异均有统计学意义(P<0.05);两组患者治疗前的RQLQ评分比较差异均无统计学意义(P>0.05);观察组患者治疗后6个月、治疗后1年的RQLQ评分分别为(0.93±0.18)分、(1.05±0.28)分,明显低于对照组的(1.62±0.12)分、(1.98±0.21)分,差异均有统计学意义(P<0.05)。结论鼻内镜下PNN切断术治疗难治性变应性鼻炎可明显改善患者的临床症状,提高生活质量,临床治疗效果显著。

Objective To observe the clinical efficacy of the resection of posterior nasal nerve(PNN)with low-temperature plasma knife via nasal endoscope in the treatment of refractory allergic rhinitis(RAR).Methods Ninety patients with RAR treated in Department of Otolaryngology,the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from March 2017 to April 2020 were selected as the research objects.According to the random number table method,they were divided into an observation group and a control group,with 45 patients in each group.Patients in the control group were treated with conservative medicine,while patients in the observation group were treated with PNN under nasal endoscopy.The efficacy and Visual Analogue Scale(VAS)scores after one month of treatment,and rhinitis-related quality of life(RQLQ)scores after six months and one year of treatment were compared between the two groups.Results The total effective rate of the observation group was 95.56%,which was significantly higher than 77.78%of the control group(P<0.05).Before treatment,there was no significant difference in VAS scores of each symptom between the two groups(P>0.05).After treatment,the VAS scores of symptoms in the two groups were significantly lower than those before treatment,and the scores of nasal congestion,nasal itching,runny nose,and sneezing in the observation group were(2.56±0.32)points,(2.28±0.11)points,(2.62±0.31)points,and(1.53±0.55)points,which were significantly lower than(2.98±0.54)points,(2.91±0.14)points,(2.91±0.46)points,and(1.87±0.62)points in the control group(P<0.05).There was no significant difference in RQLQ score between the two groups before treatment(P>0.05).The RQLQ scores at 6 months and 1 year after treatment in the observation group were(0.93±0.18)points and(1.05±0.28)points,respectively,which were significantly lower than(1.62±0.12)points and(1.98±0.21)points in the control group(P<0.05).Conclusion The resection of posterior nasal nerve with low temperature-plasma knife via nasal endoscope is able to improve the clinical symptoms,improve the quality of life,and have remarkable clinical treatment effect.