鼻内镜鼻窦手术联合低温等离子下鼻甲射频消融术对慢性鼻窦炎的疗效  

Clinical efficacy of endoscopic sinus surgery combined with radiofrequency ablation of the turbinate under low temperature plasma in treatment of chronic sinusitis

作　　者：罗敏[1] 孙刚[1] 段金芳[1] 李玉洁[1] 陈红[1] LUO Min;SUN Gang;DUAN Jin-fang;LI Yu-jie;CHEN Hong(Department of Otolaryngology Head and Neck Surgery,Chaohu Hospital Affiliated to Anhui Medical University,Chaohu Anhui 238000,China)

机构地区：[1]安徽医科大学附属巢湖医院耳鼻咽喉头颈外科,安徽巢湖238000

出　　处：《局解手术学杂志》2020年第10期832-836,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：安徽省卫生计生委科研计划项目(2016QK1030)。

摘　　要：目的探讨鼻内镜鼻窦手术联合低温等离子下鼻甲射频消融术对慢性鼻窦炎(CRS)患者嗅觉功能、鼻腔黏液纤毛清除功能的影响。方法回顾性分析2018年4月至2019年4月我院收治的80例CRS患者的临床资料,根据手术方式的不同将其分为鼻内镜组(n=38)和联合组(n=42)。比较2组患者疗效、嗅觉功能、鼻腔黏液纤毛清除功能、症状缓解情况及并发症情况。结果联合组患者临床总有效率高于鼻内镜组,差异有统计学意义(P<0.05)。2组患者术后3个月、6个月鼻塞、头面部胀痛、流脓涕、鼻涕倒流、头痛等症状评分均较术前降低(P<0.05),且联合组低于鼻内镜组(P<0.05)。2组患者术后3个月、6个月黏液纤毛清除率、黏液纤毛清除速度均较术前提高(P<0.05),糖精清除时间均较术前缩短(P<0.05),且联合组黏液纤毛清除率、黏液纤毛清除速度均高于鼻内镜组(P<0.05),糖精清除时间短于鼻内镜组(P<0.05)。联合组术后3个月、6个月嗅觉功能优于鼻内镜组(P<0.05)。2组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论鼻内镜鼻窦手术联合低温等离子下鼻甲射频消融术治疗CRS疗效确切,可有效改善患者嗅觉功能及鼻腔黏液纤毛清除功能,且不增加并发症发生率。Objective To investigate the effects of endoscopic sinus surgery combined with radiofrequency ablation of the turbinate under low temperature plasma on olfactory function and nasal mucociliary clearance in patients with chronic sinusitis(CRS).Methods The clinical data of 80 patients with CRS who were admitted into our hospital from April 2018 to April 2019 were retrospectively analyzed,and they were divided into the nasal endoscopy group(n=38)and the combined group(n=42)according to different surgical methods.The efficacy,olfactory function,nasal mucociliary clearance function,symptom relief and complications were compared between the two groups.Results The total clinical response rate of patients in the combined group was higher than that in the nasal endoscopy group,and the difference was statistically significant(P<0.05).The scores of nasal obstruction,head and facial swelling,abscess,nasal discharge,headache and other symptoms at 3 and 6 months postoperatively in both two groups were all lower than those before surgery(P<0.05),and the combined group was lower than the nasal endoscopy group(P<0.05).The mucociliary clearance rate and mucociliary clearance efficiency were improved 3 months and 6 months after operation in both groups compared with those before operation(P<0.05),the clearance time of saccharin was shorter than that before operation(P<0.05),and the mucociliary clearance rate and mucociliary clearance efficiency of the combined group were higher than those of the nasal endoscope group(P<0.05),the clearance time of saccharin was shorter than that of the nasal endoscopy group(P<0.05).The olfactory function of the combined group were better than those of the nasal endoscope group 3 months and 6 months after operation(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Endoscopic sinus surgery combined with low temperature plasma radiofrequency ablation of the turbinate is effective in the treatment of CRS,which can effect

关 键 词：鼻内镜鼻窦手术 低温等离子 鼻甲射频消融术 慢性鼻窦炎 嗅觉功能 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]