下鼻甲等离子消融的能量释放对鼻黏膜纤毛功能及组织病理改变的影响  

Effect of coblation inferior turbinate reduction on nasal mucosa

作　　者：胡洁[1] 邹坚定[2] 胡志孟[2] 范才江[2] 

机构地区：[1]浙江省慈溪市人民医院病理科,慈溪315300 [2]浙江省慈溪市人民医院耳鼻喉科,慈溪315300

出　　处：《中国眼耳鼻喉科杂志》2011年第3期137-139,205,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：浙江省医药卫生科学研究基金(2009A195)

摘　　要：目的研究下鼻甲等离子消融术(CITR)治疗慢性肥厚性鼻炎的能量释放对鼻黏膜的影响,选择最适合国人的等离子能量大小和作用时间。方法将108例慢性肥厚性鼻炎患者随机分成4组,分别用3档10s(A组)、4档10s(B组)、5档10s(C组)、3档20s(D组)行CITR,手术前后测定鼻腔黏膜纤毛传送速率和鼻阻塞视觉模拟评分,进行组间比较。同时行下鼻甲黏膜活组织检查。结果 D组术后的鼻腔黏膜纤毛传送速率明显低于术前,A组术后的鼻阻塞视觉模拟评分明显高于其他各组,差异有统计学意义(P<0.05)。病理活组织检查显示,等离子消融手术可损伤鼻黏膜。结论在行CITR时,应选4～5档能量,持续10s为宜。Objective To investigate the influence of coblation inferior turbinate reduction （CITR） on the nasal mucosa and to choose the best level and time of energy for CITR in the treatment of chronic hypertrophic rhinitis. Methods One hundred and eight patients with chronic hypertrophic rhinitis were randomly divided into four groups. CITR was performed with energy level 3 for 10 s （group A）, level 4 for 10 s （group B）, level 5 for 10 s （group C） and energy level 3 for 20 s （ group D）. The nasal mucociliary transport rate and visual analogue scale （VAS） of nasal obstruction before and after surgery was measured and compared between groups. Pathological biopsy of the nasal mucosa was carried out. Results The postoperative nasal mucociliary transport rate of group D was significantly lower than that before the operation. The postoperative VAS of nasal obstruction of group A was significantly higher than those of other groups （ P 〈 0.05）. Pathological examination showed that CITR could cause injury of the nasal mucosa. Conclusions The energy level a to 5 for 10 s was appropriate for CITR.

关 键 词：等离子下鼻甲消融术 慢性肥厚性鼻炎 鼻阻塞 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]