经鼻内镜鼻后神经切断治疗嗜酸性粒细胞型慢性鼻窦炎的短期疗效观察  

Efficacy of endoscopic posterior nasal neurectomy treating eosinophilic chronic rhinosinusitis

作　　者：张彬[1] 徐明 王卢莎 陈漫漫 ZHANG Bin;XU Ming;WANG Lusha;CHEN Manman(Department of Otolaryngology,the Affiliated Hospital of Medical School,Ningbo University,Ningbo,Zhejiang,315020,China;Department of Otolaryngology,Ningbo Municipal Hospital of TCM,Affiliated Hospital of Zhejiang Chinese Medical University,Ningbo,Zhejiang,315020,China)

机构地区：[1]宁波大学医学院附属医院耳鼻咽喉科,浙江宁波315020 [2]浙江中医药大学附属宁波中医院耳鼻咽喉科,浙江宁波315012

出　　处：《中国耳鼻咽喉头颈外科》2022年第1期45-47,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：宁波市自然科学基金(2018A610231、2019A610317)。

摘　　要：目的探讨内镜鼻窦手术结合鼻后神经切断术(posterior nasal nerve,PNN)治疗嗜酸性粒细胞型慢性鼻窦炎(eosinophilic chronic rhinosinusitis,ECRS)的临床效果。方法选择2018年1~12月在宁波大学医学院附属医院就诊的ECRS患者34例。所有患者分为两组,对照组17例单纯采取经内镜鼻窦手术方法治疗,观察组17例采用经内镜鼻窦手术结合PNN治疗。应用视觉模拟量表、鼻炎相关生活质量问卷及DIP内镜评分、Lund-Mackay鼻窦CT扫描病变范围评分来对术前、后随访资料收集分析评估,对患者治疗前和治疗结束后随访情况做自身对比,记录治疗前、手术后1年的数据。结果随访>1年。结果观察组及对照组病例治疗前主客观评分差异均无统计学意义。治疗后观察组病例流涕症状VAS评分(1.72±0.89)较对照组(2.89±1.08)显著好转(P<0.01),DIP内镜评分中分泌物评分(2.33±1.14)和鼻窦黏膜水肿或息肉评分(3.22±1.52)分别较对照组(3.56±1.65、4.33±1.41)显著好转(P<0.05),其他差异无统计学意义。结论内镜鼻窦手术结合PNN是治疗ECRS安全、有效的方法。OBJECTIVE To evaluate the therapeutic efficacy of endoscopic posterior nasal neurectomy(PNN) in the management of eosinophilic chronic rhinosinusitis(ECRS) and to explore its possible mechanism.METHODS Thirty-four patients with ECRS,who visited the Affiliated Hospital of Medical School,Ningbo University from January 2018 to December 2018,were enrolled in two groups.Endoscopic sinusitis surgery(ESS) combined with PNN was performed in 17 patients in the observation group,17 patients in the control group underwent conventional ESS.The visual analogue scale(VAS) score,rhinoconjunctivitis quality of life questionnaire(RQLQ) and Lund-Mackay score,DIP endoscopic score were assessed at 1 year after operation.RESULTS The observation group had better control of rhinorrhea(1.72±0.89 vs 2.89±1.08,P<0.001),secretions(2.33±1.14 vs 3.56±1.65,P<0.05),and edema or polyps(3.22±1.52 vs 4.33±1.41,P<0.05) in the paranasal sinus than the control group.The difference in the other scores in the observation and control groups was not statistically significant(P>0.05).CONLUSION ESS combined with PNN is an effective and safe technique in the management of ECRS.

关 键 词：内窥镜检查 鼻窦炎 嗜酸细胞 鼻后神经切断 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]