翼管神经分支切断术在持续性中重度变应性鼻炎中的疗效评估  

Evaluation of efficacy of intranasal branches neurotomy of vidian nerve in persistent moderate-severe allergic rhinitis

作　　者：刘雪峰 杨蒙生[1] 柴琳琳 卫旭东[1] 何健[1] 董小荣[2] LIU Xuefeng;YANG Mengsheng;CHAI Linlin;WEI Xudong;HE Jian;Dong Xiaorong(Department of Otolaryngology Head and Neck Surgery,Gansu Provincial People's Hospital,Lanzhou,Gansu,730000,China;Emergency Intensive Care Unit,the Second Hospital of Lanzhou University,Lanzhou,Gansu,730030,China)

机构地区：[1]甘肃省人民医院耳鼻咽喉头颈外科,甘肃兰州730000 [2]兰州大学第二医院重症医学科,甘肃兰州730030

出　　处：《中国耳鼻咽喉头颈外科》2024年第8期510-514,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：甘肃省人民医院国家级科研项目培育计划一般项目(19SYPYB-14);甘肃省省自然科学基金项目(23JRRA1637)。

摘　　要：目的评估翼管神经分支切断术对持续性中重度变应性鼻炎的疗效。方法收集甘肃省人民医院耳鼻咽喉头颈外科诊断为持续性中重度变应性鼻炎的病例,选取翼管神经分支切断术治疗的病例为治疗组,药物保守治疗的病例为对照组,应用视觉模拟量表(VAS)、鼻结膜炎生存质量调查问卷(RQLQ)、鼻呼气一氧化氮(nNO)和药物评分分别评估两组病例短期(<1年)、中期(1~3年)及长期(3~5年)预后转归。结果治疗组术后短期、中期及长期的VAS(2.26±0.75、2.30±0.63、2.49±0.57),RQLQ(0.55±0.11、0.55±0.11、1.00±0.12),nNO[(464.62±75.84)ppb、(378.63±110.21)ppb、(368.23±104.25)ppb]及药物评分(2.50±1.03、2.54±0.99、2.95±0.93)均显著低于术前[6.76±0.58、3.35±0.40、(696.64±132.69)ppb,5.17±1.50],且低于对应时间段的对照组(P均<0.05)。无与手术直接相关的严重并发症发生。结论选择性翼管神经鼻内分支切断术对中重度变应性鼻炎短、中、长期均有积极转归作用,手术安全有效。OBJECTIVE To evaluate the efficacy of intranasal branches neurotomy of vidian nerve in the treatment of persistent moderate to severe allergic rhinitis.METHODS Cases diagnosed as persistent moderate-severe allergic rhinitis in our department were collected.those treated with branches neurotomy of vidian nerve were selected as the treatment group,and those treated with conservative medicine were selected as the control group.The visual analogue scale(VAS),rhinoconjunctivitis quality of life questionnaire(RQLQ),Nitric oxide in nose(nNO)and medication score evaluation of two groups of cases were evaluated respectively short-term(<1 year),medium-term(1 to 3 years)and long-term prognosis of outcome(3 to 5 years).RESULTS The short-term,mid-term and long-term postoperative VAS(2.26±0.75,2.30±0.63,2.49±0.57),RQLQ(0.55±0.11,0.55±0.11,1.00±0.12),nNO[(464.62±75.84)ppb,(378.63±110.21)ppb,(368.23±104.25)ppb]and medication scores(2.50±1.03,2.54±0.99,2.95±0.93)were significantly lower than those before operation[6.76±0.58,3.35±0.40,(696.64±132.69)ppb,5.17±1.50)].The VAS,RQLQ,nNO and medication scores of the control group were lower than those of the control group at the corresponding time points(all P<0.05).One patient developed blindness in the right eye after interventional treatment due to epistaxis 21 days after operation,but no serious complications directly related to intranasal branches neurotomy of vidian nerve occurred.CONCLUSION The branches neurotomy of vidian nerve have a positive outcome in short,medium and long-term for persistent moderate to severe allergic rhinitis,the operation is safe and effective.

关 键 词：鼻炎 过敏 一氧化氮 翼管神经分支切断术 鼻呼气一氧化氮 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]