鼻内镜下等离子射频消融术对合并鼻窦炎的小儿腺样体肥大患者疗效及鼻腔黏膜纤毛清除功能的影响  

Clinical efficacy of endoscopic plasma radiofrequency ablation in the treatment of adenoid hypertrophy and sinusitis in children and its effect on nasal mucociliary clearance

作　　者：王驰[1] 刘星[1] 孔磊[1] 洪兴和[1] 宁博[1] WANG Chi;LIU Xing;KONG Lei;HONG Xinghe;NING Bo(Department of Otorhinolaryngology Head and Neck Surgery,The Central Hospital of Xuzhou,Xuzhou 221009,Jiangsu,China)

机构地区：[1]徐州市中心医院耳鼻咽喉头颈外科,江苏徐州221009

出　　处：《山东大学耳鼻喉眼学报》2018年第5期78-81,85,共5页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨鼻内镜下等离子射频消融术治疗小儿腺样体肥大并鼻窦炎的临床疗效及对鼻腔黏膜纤毛清除功能的影响。方法选取腺样体肥大并鼻窦炎患儿96例,随机平均分为两组,对照组采用普通手术切除法,观察组采用低温等离子射频消融法,对比两组患者的手术时间、术中出血量、鼻内镜下评分下降幅值,采用糖精试验测定手术前后鼻腔黏膜纤毛传输速率(MTR)。结果两组患者的临床疗效比较差异无统计学意义(P>0.05)。两组患者的手术时间、术中出血量及鼻内镜下评分下降幅值比较,差异有统计学意义(P<0.05)。与手术前比较,对照组患者手术后MTR差异无统计学意义(P>0.05),观察组患者手术后MTR差异有统计学意义(P<0.05);与治疗组比较,观察组患者手术后MTR差异有统计学意义(P<0.05)。结论鼻内镜下等离子射频消融术治疗小儿腺体肥大并鼻窦炎的术中出血量少、手术时间短且对患者鼻腔黏膜纤毛清除功能影响不明显,临床疗效显著。Objective To investigate the clinical efficacy of endoscopic plasma radiofrequency ablation in the treatment of adenoid hypertrophy and sinusitis in children and its effect on nasal mucociliary clearance. Methods Ninety-six children with adenoid hypertrophy and sinusitis were randomly divided into two groups： the control group,in which the children were treated with conventional surgical resection,and the observation group,in which the children were treated with low-temperature plasma radiofrequency ablation. The operative time,intraoperative blood loss,and nasal endoscopic score were compared between the two groups. The nasal mucociliary transmission rate（ MTR） was measured using the saccharin test before and after surgery. Results There was no difference between the two groups in clinical efficacy（ P〉0.05）; differences in the operative time,intraoperative blood loss,and reduced amplitude of endoscopic score were statistically significant（ P〈0.05） between the two groups. In the control group,the MTR after treatment was significantly different from that before treatment（ P〈0.05）; however,no significant difference was observed in the observation group（ P〉0.05）. and there was a significant difference in the MTR after operation in the observation group（ P〈0.05）. Conclusion Endoscopic plasma radiofrequency ablation is clinically effective for the treatment of glandular hypertrophy and sinusitis in children,and is associated with less intraoperative blood loss,shorter operative times,and no significant effect on nasal mucociliary clearance.

关 键 词：腺样体肥大 鼻窦炎 射频消融术 鼻黏膜 纤毛 

分 类 号：R729[医药卫生—儿科] R765[医药卫生—临床医学]