中鼻甲不同处理方式应用于鼻内镜鼻窦手术治疗Ⅱ型慢性鼻窦患者的效果及对NAR和VAS评分的影响

Effectiveness of Different Treatments of the Middle Turbinate Applied to Nasal Endoscopic Sinus Surgery in Pa⁃tients with Type Ⅱ Chronic Sinus and the Effect on NAR and VAS Scores

目的:探讨中鼻甲不同处理方式应用于鼻内镜鼻窦手术治疗Ⅱ型慢性鼻窦炎患者的效果及对鼻气道阻力(NAR)和视觉类比法(VAS)评分的影响。方法:选取2014年6月—2019年6月无锡市锡山人民医院收治的Ⅱ型慢性鼻窦炎患者作为研究对象,将100例患者按照随机数表法分为两组,所有患者均行经鼻内镜鼻窦手术治疗,对照组50例术中保留中鼻甲,研究组50例术中切除部分中鼻甲。比较两组患者临床疗效、NAR、VAS评分、术后清理时间、术后粘连情况以及生活质量。结果:研究组临床总有效率96.00%,对照组为80.00%,研究组高于对照组,差异有统计学意义(χ^(2)=6.061,P<0.05)。术后6个月两组NAR、VAS均低于术前,且研究组术后6个月NAR、VAS低于对照组,差异有统计学意义(t=0.928、9.309,P<0.05)。研究组术后清理时间显著短于对照组,差异有统计学意义(χ^(2)=7.162,P<0.05)。研究组术后粘连率2例(4.00%)显著低于对照组11例(22.00%),差异有统计学意义(P<0.05)。术后6个月两组患者SF-36得分均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论:鼻内镜鼻窦手术治疗Ⅱ型慢性鼻窦炎患者时,相较于保留中鼻甲而言术中切除部分中鼻甲可提高临床疗效,降低患者NAR及VAS评分,缩短术后清理时间,降低术后粘连率,患者具有较高的生活质量。

Objective:To investigate the effect of different treatments of the middle turbinate applied to patients with type Ⅱ chronic sinusitis treated by nasal endoscopic sinus surgery and the effect on nasal airway resistance(NAR)and visual analogy(VAS)scores.Methods:One hundred patients with type Ⅱ chronic rhinosinusitis admitted to the hospital from June 2014 to June 2019 were selected for the study and divided into two groups according to the random number table method,with 50 cases in each group.All patients were treated with transnasal endoscopic sinus surgery,with the middle turbinate preserved in the control group and part of the middle turbinate removed in the study group.The clinical outcomes,NAR and VAS scores,postoperative cleanup time,postoperative adhesions,and quality of life were compared between the two groups.Results:The total clinical effective rate of the study group was 96.00%,which was higher than that of the control group of 80.00%,with a statistically significant difference(χ^(2)=6.061,P<0.05).The NAR and VAS of both groups were lower than those before surgery at 6 months after surgery,and the NAR and VAS of the study group were lower than those of the control group,with statistically significant differences(t=0.928,9.309,P<0.05).The postoperative cleanup time was significantly shorter in the study group than in the control group,with a statis⁃tically significant difference(χ^(2)=7.162,P<0.05).The rate of postoperative adhesions in the study group was 2 cases(4.00%),which was significantly lower than 11 cases(22.00%)in the control group,and the difference was statistically significant(P<0.05).The SF-36 scores of both groups at 6 months after surgery were higher than those before surgery,and the study group was higher than the control group,and the difference was statistically significant(P<0.05).Conclusion:When endoscopic sinus surgery is performed to treat patients with type Ⅱ chronic sinusitis,intraoperative partial removal of the middle turbinate improves clinical out⁃comes,reduces NAR and VAS scores,shortens postoperative cleanup time,reduces postoperative adhesion rates,and provides pa⁃tients with a higher quality of life compared to preserving the middle turbinate.