低温等离子射频消融术与微波消融术治疗中重度持续性变应性鼻炎  

Efficacy of radiofrequency ablation and microwave for moderate-severe persistent allergic rhinitis

作　　者：熊洪斌[1,2] 钱洁[1,2] 王惠华[1,2] 敖智晶[1,2] 石润杰[3] 

机构地区：[1]上海市奉贤区奉城医院 [2]上海交通大学医学院附属第九人民医院奉城分院耳鼻咽喉科,上海201411 [3]上海交通大学医学院附属第九人民医院耳鼻咽喉科,上海200011

出　　处：《中国耳鼻咽喉头颈外科》2011年第5期251-253,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：上海市奉贤区卫生局课题资助[奉卫科(青)2010-02)]

摘　　要：目的探讨低温等离子射频消融术与微波消融术治疗中重度持续性变应性鼻炎(persistent allergic rhinitis,PAR)的有效性与安全性。方法将2008年8月以来入选的56例中重度PAR患者随机分为等离子治疗组(A组)和微波治疗组(B组),每组28例。鼻内镜下对双侧鼻丘及下鼻甲进行黏膜下消融治疗。术前和术后12个月进行鼻塞症状的视觉模拟量表(visual analogue scale,VAS)评分和糖精实验法测定鼻腔黏膜纤毛输送率(mucociliary transport rate,MTR),1年后观察分析疗效。结果 A组总有效率(100%)优于B组(78.57%),差异有显著性(t=6.72,P<0.01)。两组术后鼻塞VAS评分均较术前减低,差异有显著性(A组:t=13.78,P<0.01;B组:t=11.97,P<0.01);两组间术前、术后VAS评分差异具有显著性(术前:t=1.05,P>0.05;术后:t=1.32,P>0.05)。A组术后与术前MTR无差异(t=1.75,P>0.05),B组术后MTR较术前显著减低,差异有性(t=10.66,P<0.01);两组间比较,术前MTR值无差异(t=1.17,P>0.05),治疗后差异有显著性(t=10.79,P<0.01)。结论鼻内镜下低温等离子射频消融术治疗中重度PAR的方法优于微波治疗,可作为中重度PAR的治疗方法之一。OBJECTIVE To study the effectiveness and the safety of radiofrequency ablation and microwave system for moderate-severe persistent allergic rhinitis.METHODS Fifty six patients were randomly divided into two groups： radiofrequency ablation group（group A,n=28）and microwave system group（group B,n=28）.The visual analogue scales（VAS）and mucus transport rate（MTR）were measured before and 12 months after operation.RESULTS The effectiveness of group A（100%）was better than that of group B（78.57%）（P0.01）.The VAS of nasal obstruction after operation in group A and B were lower than those before operation（P0.01）.The MTR was no change in group A after operation（P0.05）,while the MTR after operation was lower than that before operation in group B（P0.01）.The MTR after operation in group B was lower than that in group A（P 0.01）.CONCLUSION Radiofrequency ablation for moderate-severe persistent allergic rhinitis has many advantages than microwave.It is a better therapeutic method for moderate-severe persistent allergic rhinitis.

关 键 词：鼻炎 变应性 常年性 内窥镜检查 微波 疼痛测定 黏膜纤毛清除 射频消融术 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]