鼻内镜术中不同鼻甲处理方式对慢性鼻-鼻窦炎患者鼻腔功能及嗅觉功能恢复的影响

Effects of Different Turbinate Treatments During Nasal Endoscopy on Recovery of Nasal Function and Olfactory Function in Patients with Chronic Rhinosinusitis

目的探讨鼻内镜术中应用不同鼻甲处理方式治疗对慢性鼻-鼻窦炎患者鼻腔功能及嗅觉功能恢复的影响。方法选取2019年6月至2021年6月在洛阳市第三人民医院行鼻内镜手术治疗的128例慢性鼻-鼻窦炎患者作为研究对象,采用随机数字表法分为两组,各64例。A组接受鼻内镜中鼻甲部分切除术,B组接受鼻内镜Messerklinger中鼻甲成形术。两组均随访至术后3个月,比较术后3个月时两组炎症反应[白介素6(IL-6)、白介素-12(IL-12)]、鼻腔功能[鼻腔容积(NCV)、鼻腔最小横截面积(NMCA)、鼻腔最小横截面至前鼻孔距离(DCAN)、呼吸道阻力]及嗅觉功能恢复情况(T&T标准嗅觉测试)。结果两组术前及术后3个月IL-6、IL-12水平相比,差异无统计学意义(P>0.05);两组术后3个月IL-6、IL-12水平低于术前(P<0.05);术后3个月,两组NCV、NMCV高于治疗前,DCAN、呼吸道阻力低于治疗前,B组NCV、NMCV高于A组,DCAN、呼吸道阻力低于A组(P<0.05);术后3个月,两组嗅觉功能评分低于术前,B组低于A组(P<0.05)。结论两种鼻甲处理方式对慢性鼻-鼻窦炎患者炎症反应的抑制效果相当,相比鼻内镜中鼻甲部分切除术,慢性鼻-鼻窦炎患者鼻内镜术中应用鼻内镜Messerklinger中鼻甲成形术的效果较好,可改善患者的鼻腔功能,促进嗅觉功能恢复。

Objective To investigate the effects of different turbinate treatment methods on the recovery of nasal function and olfactory function in patients with chronic rhinosinusitis.Methods A total of 128 patients with chronic rhinosinusitis who underwent endoscopic surgery in Luoyang Third People’s Hospital from June 2019 to June 2021 were selected as the research subjects.A random number table method was used to divide them into two groups with 64 cases in each group.Group A was treated with endoscopic partial turbinectomy,and group B was treated with endoscopic Messerklinger middle turbinoplasty.Both groups were followed up to 3 months after operation.The inflammatory response[interleukin-6(IL-6),interleukin-12(IL-12)],nasal function[nasal volume(NCV),nasal minimum cross-sectional area(NMCA),distance from nasal minimum cross-section to anterior nostril(DCAN),airway resistance]and olfactory function recovery(T&T standard olfactory test)were compared between the two groups at 3 months after operation.Results There was no statistical significant difference in the levels of IL-6 and IL-12 between the two groups before and 3 months after operation(P>0.05).The levels of IL-6 and IL-12 in both groups 3 months after operation were lower than those before operation,with a statistical significant difference(P<0.05).Compared with before treatment,the NCV and NMCV of both groups were higher,and the DCAN and airway resistance were lower 3 months after operation.Compared with group A,the NCV and NMCV of group B were higher,and the DCAN and airway resistance were lower,with statistical significant differences(P<0.05).Three months after operation,the scores of olfactory function in both groups were lower than those before operation,and group B was lower than that in group A,with statistical significant differences(P<0.05).Conclusion The two methods of turbinate treatment have the same inhibitory effect on inflammatory response in patients with chronic rhinosinusitis.Compared with endoscopic partial turbinectomy,endoscopic Messerklinger middle turbinoplasty in patients with chronic rhinosinusitis has a better effect,which can improve the nasal function and promote the recovery of olfactory function.