不同手术方法治疗伴鼻腔解剖变异和(或)炎症的常年性变应性鼻炎的效果比较  

Comparison of the clinical effects of different surgical methods for treating perennial allergic rhinitis with nasal anatomical variations and(or)inflammation

作　　者：许俊芳 马佳 齐森 王旭 甘金霞 孙露 蒙柏丽 XU Junfang;MA Jia;QI Sen;WANG Xu;GAN Jinxia;SUN Lu;MENG Baili(Department of Otolaryngology,Donghui Hospital of Guigang City,Guangxi 537100,China;Department of Otolaryngology,Jixi People′s Hospital,Heilongjiang 158100,China)

机构地区：[1]贵港市东晖医院耳鼻喉科,广西537100 [2]鸡西市人民医院耳鼻喉科,黑龙江158100

出　　处：《中国临床新医学》2024年第12期1393-1397,共5页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：贵港市自筹经费科研项目(编号:贵科攻2200034)。

摘　　要：目的比较不同手术方法治疗伴鼻腔解剖变异和(或)炎症的常年性变应性鼻炎(AR)的效果。方法回顾性分析2021年12月至2023年8月贵港市东晖医院和鸡西市人民医院收治的150例伴鼻腔解剖变异和(或)炎症的常年性AR患者的临床资料,根据手术方法不同将其分为对照组(接受下鼻甲黏膜下骨质部分切除术,或鼻中隔矫正术+下鼻甲黏膜下骨质部分切除术,75例)和观察组(接受高选择性翼管神经分支切断术+下鼻甲黏膜下骨质部分切除术,或高选择性翼管神经分支切断术+鼻中隔矫正+下鼻甲黏膜下骨质部分切除术,75例)。采用视觉模拟量表(VAS)评估两组患者术前及术后6个月、12个月的鼻部症状。比较两组术后6个月、12个月的临床疗效及术后并发症发生情况。结果两组术后鼻塞、鼻痒、流涕和喷嚏的VAS评分均呈下降趋势,且观察组降幅较对照组更大(P<0.05)。观察组术后6个月、12个月的鼻塞、鼻痒、流涕和喷嚏的VAS评分均低于对照组,差异有统计学意义(P<0.05)。两组术后6个月的临床疗效相当(P>0.05),观察组术后12个月的临床总有效率显著高于对照组(97.33%vs 72.00%;χ^(2)=18.538,P<0.001)。观察组发生上腭麻木1例,头痛3例,无干眼症和鼻腔出血发生。对照组无手术相关并发症发生。两组并发症发生率比较差异无统计学意义(5.33%vs 0.00%;P=0.056)。结论高选择性翼管神经分支切断术+下鼻甲黏膜下骨质部分切除术,或高选择性翼管神经分支切断术+鼻中隔矫正+下鼻甲黏膜下骨质部分切除术治疗常年性AR的临床疗效显著,且安全性良好,值得临床推荐。Objective To compare the clinical effects of different surgical methods for treating perennial allergic rhinitis(AR)with nasal anatomical variations and(or)inflammation.Methods The clinical data of 150 patients suffering from perennial AR with nasal anatomical variations and(or)inflammation who were admitted to Donghui Hospital of Guigang City and Jixi People′s Hospital from December 2021 to August 2023 were retrospectively analyzed.According to different surgical methods,the patients were divided into control group(receiving submucosal inferior turbinate bone resection or septoplasty+submucosal inferior turbinate bone resection,75 cases)and observation group(receiving selective vidian nerve transection+submucosal inferior turbinate bone resection,or selective vidian nerve transection+septoplasty+submucosal inferior turbinate bone resection,75 cases).Visual Analogue Scale(VAS)scores were used to evaluate the nasal symptoms of the patients in the two groups before surgery and at 6 and 12 months after surgery.The clinical effects and the incidence of postoperative complications were compared between the two groups at 6 and 12 months after surgery.Results The VAS scores for postoperative nasal congestion,nasal itching,runny nose,and sneezing in both groups showed a decreasing trend,and the reductions of these VAS scores in the observation group were greater than those in the control group(P<0.05).The VAS scores for nasal congestion,nasal itching,runny nose and sneezing in the observation group were lower than those in the control group at 6 and 12 months after surgery,and the differences were statistically significant(P<0.05).The clinical effects in the two groups were equivalent at 6 months after surgery(P>0.05),while the total clinical effective rate of the observation group at 12 months after surgery was significantly higher than that of the control group(97.33%vs 72.00%;χ^(2)=18.538,P<0.001).In the observation group,there was 1 case of palatal numbness,3 cases of headache,and no cases of dry eye syndrome and

关 键 词：高选择性翼管神经分支切断术 下鼻甲黏膜下骨质部分切除术 鼻中隔矫正 变应性鼻炎 鼻腔解剖变异 临床效果 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]