下鼻甲等离子减容术对鼻腔功能的影响  

Effect of coblation inferior turbinate reduction on nasal function

作　　者：龚梁[1] 徐建群[1] 潘叶挺[1] 邹坚定[1] 

机构地区：[1]慈溪市人民医院耳鼻喉科,315300

出　　处：《浙江医学》2012年第3期169-172,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生科研基金项目（2009A195）

摘　　要：目的 探讨等离子下鼻甲减容术（CITR）对鼻腔功能的影响,研究最适宜的等离子能量大小和消融作用时间.方法 将108 例患者随机分成4 组,按时间、能量梯度分别采用3档10s（A 组）、4 档10s（B 组）、5 档10s（C 组）、3 档20s（D 组）行CITR 手术,测定患者手术前后的鼻阻塞视觉模拟评分（VAS）、鼻阻力、鼻腔黏膜纤毛传送速率（MTR）,并进行组间比较;同时对各组患者手术前后下鼻甲黏膜行病理检查并比较.结果 4组患者术后鼻阻塞VAS及鼻阻力均明显低于术前,差异有统计学意义（均P＜0.01）;A组术后鼻阻塞VAS 及鼻阻力明显高于其他各组,差异有统计学意义（P＜0.01）;B、C、D 组间的差异无统计学意义（P＞0.05）.A、B 两组术前、术后MTR 差异无统计学意义（P＞0.05）,C、D 组术后MTR低于术前,差异有统计学意义（P＜0.05 或0.01）.C、D 组术后鼻腔黏膜病理结果显示纤毛脱落、腺体灼伤.结论 CITR 对鼻黏膜可能产生损伤,行CITR 操作时应选4 档能量,持续时间10s 为宜.Objective To investigate the effect of coblation inferior turbinate reduction （CITR） on nasal function. Methods One hundred and eight patients undergoing CITR surgery were randomly divided into 4 groups. In each group CITR was per- formed with energy level 3 for 10 sec （group A）, level 4 for 10 sec （group B）, level 5 for 10 sec （group C） and energy level 3 for 20 sec （group D）, respectively. The visual analogue scale （VAS） of nasal obstruction, nasal resistance （NR） and nasal mucociliary transfer rate （MTR） were measured before and after surgery and compared among groups. Pathological biopsy of the nasal mucosa was undertaken before and after surgery. Results The postoperative VAS and NR scores of each group were lower than those before operation with statistically significant difference （P〈0.01）. The postoperative VAS and NR scores of group A were higher than other groups with statistically significant difference（P〈0.01）. The difference among group B, C and D was not statisti- cally significant （P 〉0.05）. The MTR of group A and B after surgery was not significantly different compared with the MTR before the operation （P 〉0.05）.The postoperative nasal MTR of group C and D was lower than the preoperative MTR with statistically significant difference （P〈0.05 or P〈0.01）. Pathological examination showed loss of cilia and heat injury of gland in group C and D. Conclusion CITR may cause injury of nasal mucosa. The energy level 4 lasting for 10 seconds is appropriate for CITR.

关 键 词：等离子下鼻甲减容术 鼻功能 鼻阻塞 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]