对比鼻内镜Messerklinger中鼻甲成形术与鼻内镜中鼻甲部分切除术治疗CRSwNP患者的疗效

Therapeutic efficacy of nasal endoscopic Messerklinger's middle turbinoplasty vs nasal endoscopic partial turbinate resection in treatment of CRSwNP

目的:比较分析鼻内镜Messerklinger中鼻甲成形术、鼻内镜中鼻甲部分切除术治疗慢性鼻⁃鼻窦炎伴鼻息肉(CRSwNP)患者的效果。方法:选取我院98例(2018年12月~2021年1月)CRSwNP患者,依照随机数字表法分为两组,各49例。A组接受鼻内镜中鼻甲部分切除术治疗,B组接受鼻内镜Messerklinger中鼻甲成形术,比较两组治疗效果。结果:疗效:B组总有效率较A组高(P<0.05);鼻腔功能:术后3个月,两组鼻腔功能均得到改善,且B组鼻腔最小横截面积(NMCA)、鼻腔容积(NCV)较A组高,气道阻力、鼻腔最小横截面至前鼻孔距离(DCAN)较A组小(P<0.05);炎性应激:术后1 d,两组均出现炎性应激反应,而B组人软骨糖蛋白⁃39(YKL⁃40)、白细胞介素⁃5(IL⁃5)、转化生长因子⁃β1(TGF⁃β1)均低于A组(P<0.05)。结论:与鼻内镜中鼻甲部分切除术对比,鼻内镜Messerklinger中鼻甲成形术治疗CRSwNP,效果显著,能有效改善鼻腔功能,减小炎性应激。

Objective:To investigate the therapeutic efficacy of nasal endoscopic Messerklinger's middle turbinoplasty vs nasal endoscopic partial turbinate resection in treatment of chronic rhinosinusitis with nasal polyps(CRSwNP).Methods:A total of 98 CRSwNP patients who stayed in our hospital between December 2018 and January 2021 were enrolled and divided into two groups according to the random number table(n=49 each).The group A received partial resection of middle turbinate under nasal endoscopy,while the group B received nasal endoscopic Messerklinger's middle turbinoplasty.The therapeutic efficacy was compared between the two groups.Results:Regarding efficacy,total effective rate was higher in group B than that in group A(P<0.05).Regarding nasal function,either group experienced improvement in nasal function at 3 months after operation.Compared with group A,group B showed greater nasal minimum cross⁃sectional area(NMCA)and nasal cavity volume(NCV),lower airway resistance and shorter distance from the smallest cross⁃section of the nasal cavity to the anterior nostril(DCAN)(P<0.05).Regarding the inflammatory stress,either group showed inflammatory stress on day 1 after operation;however,the group B had lower human cartilage glycoprotein⁃39(YKL⁃40),interleukin⁃5(IL⁃5),and transforming growth factor⁃β1(TGF⁃β1)levels compared with group A(P<0.05).Conclusion:Compared with nasal endoscopic partial turbinate resection,nasal endoscopic Messerklinger's turbinoplasty for treatment of CRSwNP offers significant efficacy with effective improvement in nasal function and less inflammatory stress.