鼻内镜鼻后神经分支切断对CSNP伴AR的疗效及TNF⁃α、IL⁃18的影响  

The therapeutic effect of endoscopic resection of posterior nasal nerve branches on CSNP with AR and the influence of TNF⁃α,IL⁃18

作　　者：何金强 吴俊[1] 方玉香[1] HE Jinqiang;WU Jun;FANG Yuxiang(Department of Otolaryngology,Huangshan Shoukang Hospital,Huangshan,Anhui,China,245000)

机构地区：[1]黄山首康医院耳鼻喉科,安徽黄山245000

出　　处：《分子诊断与治疗杂志》2023年第9期1478-1482,共5页Journal of Molecular Diagnostics and Therapy

基　　金：黄山市科技计划项目(2020KN⁃13)。

摘　　要：目的探讨鼻内镜下鼻后神经分支切断治疗慢性鼻窦炎鼻息肉(CSNP)伴变应性鼻炎(AR)的疗效及对肿瘤坏死因子(TNF⁃α)、白细胞介素⁃18(IL⁃18)的影响。方法选取2020年5月至2022年12月黄山首康医院收治的100例CSNP伴AR患者,随机分为观察组和对照组各50例,对照组给予常规鼻内镜下鼻窦手术,观察组实施常规鼻内镜下鼻窦手术加低温等离子鼻后神经分支切断术。分析两组临床疗效及TNF⁃α、IL⁃18变化,并收集两组手术情况、疼痛评分、生活质量及术后并发症情况。结果观察组的治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组手术后IL⁃18、TNF⁃α水平及鼻痒、鼻涕、喷嚏、鼻塞评分低于对照组,差异有统计学意义(P<0.05)。观察组的手术时间、症状消退时间、术中出血量、住院时间较对照组缩短明显,差异有统计学意义(P<0.05)。观察组手术后RQLQ、VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于照组,差异有统计学意义(P<0.05)。结论鼻内镜下鼻后神经分支切断可以改善CSNP伴AR患者的临床症状,提高其生活质量。Objective To analyze the efficacy of posterior nasal nerve branch resection under nasal endoscopy in the treatment of CSNP with AR and its impact on TNF⁃α,IL⁃18.Methods 100 CSNP patients with AR admitted to Huangshan Shoukang Hospital from May 2020 to December 2022 were randomly divided into an observation group and a control group of 50 cases each.The control group received conventional endoscopic sinus surgery,while the observation group received plasma posterior nasal nerve branch resection.The clinical efficacy and TNF⁃α,IL⁃18 between the two groups were analyzed.The surgical conditions,pain scores,quality of life and postoperative complications of the two groups were collected.Results The total effective rate of treatment in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05).The levels of IL⁃18 and TNF⁃αand the scores of nasal itching,runny nose,sneezing and nasal congestion in the observation group were lower than those in the control group after operation,and the difference was statistically significant(P<0.05).The operation time,symptom subsidence time,intraoperative blood loss,and hospitalization time in the observation group were significantly shorter than those in the control group,and the difference was statistically significant(P<0.05).After operation,the RQLQ and VAS scores in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was lower than that in the control group,with a statistically significant difference(P<0.05).Conclusion Resection of the posterior nasal nerve branch under nasal endoscopy can improve the clinical symptoms and quality of life of patients with CSNP and AR.

关 键 词：变应性鼻炎 鼻窦炎鼻息肉 等离子消融术 鼻内镜 鼻窦开放术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]