下鼻甲射频消融术对慢性鼻-鼻窦炎患者鼻腔结构及气道阻力的影响  

Influence of radiofrequency ablation of inferior turbinate on nasal structure and airway resistance in patients with chronic rhinosinusitis

作　　者：魏艳艳[1] 李颖[1] 僧东杰 崔艳红[1] 徐艳霞 韩富根 段清川 WEI Yanyan;LI Ying;SENG Dongjie;CUI Yanhong;XU Yanxia;HAN Fugen;DUAN Qingchuan(Department of Otolaryngology,Head and Neck Surgery,Children’s Hospital Affiliated to Zhengzhou University,Henan Children’s Hospital Zhengzhou Children’s Hospital,Zhengzhou Henan 450018,China;Department of Otolaryngology,Head and Neck Surgery,National Center for Children’s Health,Beijing Children’s Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院耳鼻咽喉头颈外科,河南郑州450018 [2]国家儿童医学中心,首都医科大学附属北京儿童医院耳鼻咽喉头颈外科,北京100045

出　　处：《中国临床医生杂志》2024年第8期903-907,共5页Chinese Journal For Clinicians

摘　　要：目的探究下鼻甲射频消融术对慢性鼻-鼻窦炎患者鼻腔结构及气道阻力的影响。方法选取2019年1个月至2024年6月河南省儿童医院收治的64例慢性鼻-鼻窦炎患者,在组间基线资料匹配的基础上,采用随机信封法将上述患者分为对照组(n=32,实施鼻内镜鼻窦手术)和观察组(n=32,实施鼻内镜鼻窦手术配合下鼻甲射频消融术),比较两组患者手术相关指标、疗效、鼻腔结构、气道阻力、鼻黏液纤毛清除功能、并发症。结果两组患者术中出血量比较差异无统计学意义(P>0.05);观察组患者住院时间相较于对照组更短,总有效率更高,差异有统计学意义(P<0.05)。相较于治疗前,治疗后两组患者宽敞侧及狭窄侧下鼻甲最下缘与鼻底的垂直距离、下鼻甲最内缘与鼻中隔的水平距离均有增长,且观察组相较于对照组更长,差异有统计学意义(P<0.05)。治疗后两组患者宽敞侧及狭窄侧下鼻甲水平方向上的最大厚度均有降低,且观察组相较于对照组更低,差异有统计学意义(P<0.05)。治疗后两组患者呼吸总阻抗、总气道阻力、共振频率均有降低,且观察组相较于对照组更低(P<0.05)。治疗后两组患者黏液纤毛清除率、黏液纤毛清除速率均有升高,且观察组相较于对照组更高;治疗后两组患者糖精清除时间均有降低,且观察组相较于对照组更低,差异有统计学意义(P<0.05)。观察组患者治疗后鼻内镜Lund-Kennedy评分低于对照组,并发症总发生率相低于对照组,差异有统计学意义(P<0.05)。结论相较于单独实施鼻内镜鼻窦手术,实施鼻内镜鼻窦手术配合下鼻甲射频消融术对于慢性鼻-鼻窦炎患者而言,既可降低术中出血量,又可缩短住院时间,提升疗效,改善鼻腔结构与鼻黏液纤毛清除功能,降低气道阻力,减少并发症发生率,具有应用价值。Objective To explore the influence of radiofrequency ablation of inferior turbinate on nasal structure and airway resistance in patients with chronic rhinosinusitis.Methods 64 patients with chronic rhinosinusitis in Zhengzhou Children’s Hospital from January 2019 to March 2024 were studied and divided into control group(n=32,endoscopic sinus surgery)and observation group(n=32,endoscopic sinus surgery combined with radiofrequency ablation of inferior turbinate)by adopting the random envelope method.The surgery-related indicators,efficacy,nasal structure,airway resistance,nasal mucociliary clearance function and complications were compared between both groups of patients.Results There was no difference in intraoperative blood loss between both groups(P>0.05).The hospital stay in observation group was shorter than that in control group(P<0.05).The total effective rate was higher in observation group than that in control group(P<0.05).Compared with before treatment,the vertical distance between the lower edge of the inferior turbinate and the nasal floor on the spacious side and the narrow side and the horizontal distance between the innermost edge of the inferior turbinate and the nasal septum were increased in both groups after treatment,and the observation group had longer distances than the control group(P<0.05).The maximum thicknesses of the horizontal direction of the inferior turbinate on the spacious side and the narrow side of the two groups of patients were decreased after treatment compared with those before treatment,and the observation group had thinner thicknesses(P<0.05).Compared with before treatment,the total respiratory impedance(Z5),total airway resistance(R5)and resonance frequency(FRES)were declined in both groups after treatment,and the Z5,R5 and FRES in observation group were lower compared to control group(P<0.05).The mucociliary transport rate(MTR)and mucociliary clearance rate(MCT)in both groups after treatment were risen compared to before treatment,and the observation group had higher MT

关 键 词：下鼻甲射频消融术 慢性鼻-鼻窦炎 鼻腔结构 气道阻力 并发症 

分 类 号：R675.41[医药卫生—外科学]