鼻内窥镜下等离子治疗变应性鼻炎效果观察

Effects of anterior-ethmoid neurotomy on treating allergic rhinitis by plasma and the pathologic observation of incision section

目的 :观察等离子治疗常年性变应性鼻炎 (PAR)的作用机制、疗效 ,探讨等离子处理鼻腔黏膜病变的适应范围和注意事项。方法 :在鼻内窥镜下用等离子治疗仪切断 46例 ( 81侧 )PAR患者鼻腔的筛前神经 ,用计分法分别评定治疗前后 (观察期为 1年 )患者的临床症状、体征 ;另取游离的成人钩突、中鼻甲和下鼻甲 ,用等离子切割其鼻黏膜 ,并在光镜下观察组织切片的病理变化。结果 :在等离子治疗组 ,显效 31例 ,有效 15例 ,治疗前后症状及体征改善明显 ,计分值由治疗前的 12 .93降为治疗后的6.14 ,其差异有显著性 (P <0 .0 0 1) ;组织切片示切割区黏膜气化彻底 ,而周围 0 .1mm范围外的组织在急性期无明显变性。结论 :等离子切断筛前神经是治疗PAR的一种有效而简便的方法 ,亦可应用于鼻腔 (包括鼻中隔骨部 )黏膜病变的止血、切割和气化 ,但对鼻腔顶部 (筛板处 )

Objective To confirm the curative effect of plasma on perennial allergic rhinitis (PAR) and to study the therapical mechanism.Methods The anterior-ethmoid neurotomy was performed in 46 cases (81 procedures) using plasma by intranasal endoscopic surgery.Clinical symptoms and physical sign before and after operation were evaluated,and the pathologic change of the incision sections was observed.Results In operative group with plasm(46 cases,81 sides),the apparent rate was 32.6%(15 cases),the effective rate was 67.4%(31 cases),the average counting-score reduce from 12.93 pre-operation to 6.14 post-operation(P<0.001).The sample of nasal cavity tissue showed complete aerification on the incision areas and no evident denaturation outside 0.1mm of it.Conclusion The anterior-ethmoid neurotomy with plasma is an effective and simple therapical technique for treating PAR,it can also be applied in hemostasis,incision and aerification in nasal cavity including nasal septum mallet.