2种不同中鼻甲成形术在慢性鼻窦炎鼻内镜术中的应用效果比较

Comparison of therapeutic effects oftwo kinds of middle turbinoplasty in endoscopic sinus surgery

目的比较2种中鼻甲成形术在慢性鼻窦炎鼻内镜手术治疗中同期修正中鼻甲异常的治疗效果。方法选取2016年1月至2021年4月合肥市第二人民医院耳鼻咽喉科治疗的慢性鼻-鼻窦炎伴中鼻甲结构异常患者82例,按照随机数字表法分为观察组和对照组,各41例。观察组行保留中鼻甲骨完整性的中鼻甲成形术,对照组行中鼻甲黏膜并中鼻甲骨部分切除的中鼻甲成形术。随访6~36个月,对比两组治疗总有效率、患者临床总满意度及术后并发症(出血、粘连、中鼻甲漂移及鼻腔去黏膜化或空鼻症)总发生率差异。结果两组治疗总有效率比较,差异无统计学意义(χ^(2)=0.213,P=0.644)。对照组出血1例、术后粘连2例,术后并发症总发生率为7.32%;观察组出血2例,术后并发症总发生率为4.88%,两组差异无统计学意义(χ^(2)=0.213,P=0.644)。对照组患者总满意度90.24%,观察组患者总满意度92.68%,两组差异无统计学意义(χ^(2)=0.156,P=0.693)。结论保留中鼻甲骨完整性的中鼻甲成形术保留了更多的中鼻甲黏膜和中鼻甲骨,保留了中鼻甲的基本形态轮廓未改变,更有利于鼻腔及中鼻甲生理功能的恢复和发挥,更值得推广和应用。

Objective To compare the therapeutic effects of two types of middle turbinoplasty in endoscopic sinus surgery.Methods A total of 82 patients with chronic rhinosinusitis and abnormal middle turbinate who received treatment in the Otolaryngology Department at the Second People’s Hospital of Hefei from January 2016 to April 2021 were selected in the study and divided by random number table into observation group and control group,with 41 cases in each group.The middle turbinoplasty preserving the integrity of middle turbinate bone was performed in the observation group,and the middle turbinoplasty with partial resection of the middle turbinate bone and mucosa was performed in the control group.After 6~36 months of follow-up,the total effective rate,patient satisfaction and incidence of post-operative complications(bleeding,adhesions,middle turbinate“drifting”and nasal mucosa or empty nose syndrome)between the two groups were compared and analyzed.Results There was no statistically significant difference in the total effective rate between the two groups(χ^(2)=0.213,P=0.644).There was one case of bleeding,two cases of adhesion and 7.317%of incidence of postoperative complications in the control group,while there were two cases of bleeding and 4.878%of incidence of postoperative complicationsin the observation group.So the difference between the two groups was not statistically significant(χ^(2)=0.213,P=0.644).The total patient satisfaction rate was 90.244%in the control group and 92.683%in theobservation group,with no statistically significant difference between the two groups(χ^(2)=0.156,P=0.693).Conclusions Middle turbinoplasty that preserves the integrity of the middle turbinate bone can keep more of the middle turbinate mucosa and middle turbinate bone,and retain the main shape of the middle turbinate,which promotes the recovery of the physiological functions of the nasal cavity and the middle turbinate,ensuring its normal function,thus itis worth wide application.