下鼻甲骨折外移保留功能在慢性鼻窦炎患者中的应用效果

Effectiveness of External Displacement of Inferior Turbinate Fracture to Preserve Function in Patients With Chronic Sinusitis

目的探究下鼻甲骨折外移保留功能与下鼻甲部分切除术对慢性鼻窦炎患者主要症状评分及相关临床指标的影响差异。方法入选对象为2021年10月—2022年10月福建省地质医院收治的80例慢性鼻窦炎患者,采用随机法分组,研究组与对照组各40例。研究组施以下鼻甲骨折外移保留功能术治疗,对照组施以下鼻甲部分切除术治疗。对比两组临床相关指标、主要症状评分[Lund-Mackey鼻窦CT评分、最小横截面积(minimal cross-sectional area,MCA)]、鼻道纤毛清除速度、嗅觉功能恢复效果。结果研究组的术中出血量低于对照组,手术时间、鼻黏膜恢复时间、术后鼻腔疼痛时间、住院时间均短于对照组,差异有统计学意义(t=9.623,P<0.001;t=5.931,P<0.001;t=3.071,P=0.003;t=11.260,P<0.001;t=12.593,P<0.001)。研究组治疗后的MCA(0.68±0.15)cm^(2)和鼻道纤毛清除速度(5.85±0.18))g/L均高于对照组的MCA(0.62±0.11)cm^(2)和鼻道纤毛清除速度(5.41±0.12)g/L,差异有统计学意义(t=2.040,P<0.001;t=18.711,P<0.001)。研究组的Lund-Mackey鼻窦CT评分(2.58±1.13)分低于对照组(4.81±0.12)分,差异有统计学意义(t=7.816,P<0.001)。研究组的并发症发生率低于对照组,差异有统计学意义(χ^(2)=4.110,P=0.043)。研究组的嗅觉功能恢复率高于对照组,差异有统计学意义(χ^(2)=6.130,P=0.013)。结论下鼻甲骨折外移保留功能术可提高慢性鼻窦炎患者的疗效,减少术中出血量,促进患者嗅觉功能的恢复,减少术后并发症的发生,加快术后快速恢复。

Objective To investigate the differences in the effects of external displacement of inferior turbinate fractures to preserve function versus partial inferior turbinate resection on major symptom scores and related clinical indicators in patients with chronic rhinosinusitis.Methods In this study,a total of 80 patients with chronic rhinosinusitis admitted to Fujian Provincial Geological Hospital from October 2021 to October 2022 were collected,and were grouped by randomization method,with 40 cases each in the study group and the control group.The study group was treated with external displacement of inferior turbinate fracture to preserve function,and the control group was treated with partial inferior turbinate resection.The two groups were compared in terms of clinical related indexes,major symptom scores[Lund-Mackey sinus CT score,minimum cross-sectional area(MCA)],nasal tract cilia clearance speed,and olfactory function recovery effect.Results The intraoperative bleeding in the study group was lower than that in the control group,and the operative time,nasal mucosa recovery time,postoperative nasal pain time,and hospital stay were shorter than those in the control group,which was statistically significant(t=9.623,P<0.001;t=5.931,P<0.001;t=3.071,P=0.003;t=11.260,P<0.001;t=12.593,P<0.001).MCA(0.68±0.15)cm^(2) and nasal tract cilia clearance rate(5.85±0.18)were statistically higher in the study group than in the control group(0.62±0.11)points,(5.41±0.12)points after treatment(t=2.040,P<0.001;t=18.711,P<0.001).The Lund-Mackey sinus CT score in the study group(2.58±1.13)points was statistically lower than that in the control group(4.81±0.12)points(t=7.816,P<0.001).The incidence of complications in the study group was lower than that in the control group,which was statistically significant(χ^(2)=4.110,P=0.043).The recovery rate of olfactory function in the study group was higher than that in the control group,which was statistically significant(χ^(2)=6.130,P=0.013).Conclusion External displacement of inferior turbinate fracture to preserve function can improve the outcome of patients with chronic sinusitis,reduce intraoperative bleeding,promote the recovery of olfactory function,reduce the occurrence of postoperative complications,and accelerate rapid postoperative recovery.