鼻内镜下鼻后神经、咽支联合筛前神经切断术治疗重度变应性鼻炎临床效果及对患者生活质量的影响  

Clinical efficacy of posterior nasal nerve,pharyngeal branch combined with anterior ethmoidal nerve transection under nasal endoscopy in treatment of severe allergic rhinitis and its influence on quality of life of patients

作　　者：杨超[1] 曹永华 王娟利 王忠勋 YANG Chao;CAO Yonghua;WANG Juanli;WANG Zhongxun(Department of Otolaryngology,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000,China)

机构地区：[1]陕西中医药大学第二附属医院耳鼻喉科,陕西咸阳712000

出　　处：《陕西医学杂志》2022年第4期433-436,共4页Shaanxi Medical Journal

基　　金：陕西中医药大学第二附属医院科研项目(2020XKTD-C05)。

摘　　要：目的:探究鼻内镜下鼻后神经、咽支联合筛前神经切断术治疗重度变应性鼻炎(AR)的效果及对患者生活质量的影响。方法:纳入重度AR患者74例,根据治疗方法的不同分为常规组和观察组。常规组行鼻内镜下翼管神经切断术,观察组行鼻内镜下鼻后神经、咽支联合筛前神经切断术。比较两组的近期治疗效果和并发症发生率。比较两组术前、术后3个月、术后1年、术后2年的视觉模拟量表(VAS)评分。比较两组术前和术后3个月的生活质量。结果:观察组的近期治疗有效率高于常规组,差异具有统计学意义(P<0.05)。常规组和观察组术后3个月、1年和2年的VAS评分均低于术前,差异具有统计学意义(均P<0.05)。术后3个月、1年和2年观察组的VAS评分均低于常规组,差异具有统计学意义(均P<0.05)。治疗后,两组的睡眠、鼻部症状、情感、眼部症状、实际困扰、其他症状、活动限制评分均下降,其中观察组各项评分均低于常规组,差异具有统计学意义(均P<0.05)。观察组的并发症发生率明显低于常规组,差异具有统计学意义(P<0.05)。结论:鼻内镜下鼻后神经、咽支联合筛前神经切断术治疗重度AR的近远期效果确切,能够明显改善患者生活质量,且安全性好。Objective:To study the clinical efficacy of posterior nasal nerve,pharyngeal branch combined with anterior ethmoidal nerve transection under nasal endoscopy in the treatment of severe allergic rhinitis(AR)and its influence on the quality of life of patients.Methods:A total of 74 patients with severe AR were included and divided into routine group and observation group according to different treatment methods.The routine group underwent endoscopic pterygoid neurotomy,and the observation group underwent posterior nasal nerve,pharyngeal branch combined with anterior ethmoidal nerve transection under nasal endoscopy.The recent treatment effects and the incidence of complications were compared between the two groups.The VAS scores of the two groups before operation,3 months after operation,1 year after operation,and 2 years after operation were compared between the two groups.The quality of life before and 3 months after operation was compared between the two groups.Results:The effective rate of short-term treatment in the observation group was higher than that in the routine group(P<0.05).The VAS scores of the routine group and observation group at 3 months,1 year and 2 years after operation were lower than those before operation(all P<0.05).The VAS scores of the observation group were lower than those of the routine group at 3 months,1 year and two years after operation(all P<0.05).After treatment,the scores of sleep,nasal symptoms,emotions,eye symptoms,actual distress,other symptoms and activity restriction of the two groups decreased,and the scores of the observation group were lower than those of the routine group(all P<0.05).The incidence of complications in the observation group was significantly lower than that in the routine group(P<0.05).Conclusion:Posterior nasal nerve,pharyngeal branch combined with anterior ethmoidal nerve transection under nasal endoscopy has definite short-term and long-term effects in the treatment of severe AR,which can significantly improve the quality of life of patients,and has goo

关 键 词：鼻内镜 鼻后神经 咽支 筛前神经切断术 重度变应性鼻炎 生活质量 

分 类 号：R765[医药卫生—耳鼻咽喉科]