鼻内镜下单侧鼻后神经丛切断术治疗难治性变应性鼻炎的临床研究

Clinical research of endoscopic unilateral posterior nasal plexectomy for the treatment of refractory allergic rhinitis

目的探讨鼻内镜下低温等离子单侧鼻后神经丛切断术治疗难治性变应性鼻炎(AR)的效果。方法回顾性分析武汉市第一医院耳鼻咽喉头颈外科2020年5月~2021年5月50例鼻内镜下低温等离子单侧鼻后神经丛切断术治疗难治性AR患者的临床资料,比较手术前、术后半年、术后1年的鼻部主观症状的视觉模拟量表(VAS)和鼻结膜炎相关生活质量问卷(rhinoconjunctivitis quality of life questionnaire,RQLQ)评分。结果术后半年总有效率为98%,显效率为80%,有效率为18%,无效率为2%。术后1年总有效率为84%,显效率为60%,有效率为24%,无效率为16%。术后半年、术后1年鼻部主观症状的VAS评分及RQLQ评分均低于术前,差异均有统计学意义(P<0.05)。所有患者随访期间均未出现干眼、无泪、面唇及上腭麻木等并发症。结论鼻内镜下低温等离子单侧鼻后神经丛切断术治疗难治性AR疗效确切,手术并发症少,值得临床中推广应用。

OBJECTIVE To investigate the surgical effect of endoscopic plasma unilateral postnasal neurotomy for the treatment of refractory allergic rhinitis(AR).METHODS The clinical data of 50 patients with refractory AR who were treated by endoscopic plasma unilateral posterior nasal plexus amputation from May 2020 to May 2021 in the Department of Otolaryngology Head and Neck Surgery of Wuhan First Hospital were analyzed retrospectively.The scores of the visual analogue scale(VAS)and the quality of life scale for rhinoconjunctivitis quality of life questionnaire(RQLQ)before,half a year after and 1 year after the operation were compared.RESULTS Half a year after operation,the total effective rate was 90%,markedly effective 80%,effective 18%,and ineffective 2%.One year after operation,the total effective rate was 84%,markedly effective 60%,effective 24%,and ineffective 16%.The VAS of Subjective symptoms of the nose and RQLQ scores were lower half a year and 1 year after the operation than that before the operation,and the difference was statistically significant(P<0.05).During the follow-up period,all patients did not have dry eyes,no tears,numbness of face,lip and palate and other complications.CONCLUSION Unilateral posterior nasal plexus ablation with plasma endoscope is effective in the treatment of refractory AR.It is worthy of clinical application with few surgical complications.