鼻内镜下鼻甲黏膜下骨质部分切除联合骨折外移术治疗慢性肥厚性鼻炎临床疗效及术后并发症分析  

Clinical efficacy and postoperative complications of partial submucosal turbinate bone resection under nasal endoscope combined with fractured-bone removal in treating chronic hypertrophic rhinitis

作　　者：高金凤 穆彦丽 王振华 Gao Jinfeng;Mu Yanli;Wang Zhenhua(Department of Otolaryngology,Nanyang Central Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院耳鼻咽喉科,河南南阳473000

出　　处：《感染、炎症、修复》2025年第2期120-123,共4页Infection Inflammation Repair

摘　　要：目的:探讨鼻内镜下鼻甲黏膜下骨质部分切除联合骨折外移术治疗慢性肥厚性鼻炎的临床疗效及对术后并发症的影响。方法:选取南阳市中心医院106例慢性肥厚性鼻炎患者为研究对象,按照随机数字表法分为观察组和对照组,各53例,观察组行鼻内镜下鼻甲黏膜下骨质部分切除联合骨折外移术治疗,对照组患者行等离子射频消融联合骨折外移术治疗,比较两组临床疗效,术后并发症,术前及术后6个月鼻腔容积(NCV)、气道阻力(NAR)及鼻腔黏膜状态。结果:观察组和对照组临床有效率、并发症总发生率均无显著性差异(P>0.05);术后6个月,观察组和对照组鼻腔最小横截面积(NMCA)、NCV值均显著升高(P<0.05),NAR值均显著降低(P<0.05),纤毛细胞/杯状细胞数目比值、鼻腔黏膜纤维传输速率(MTR)值均显著升高(P<0.05),且观察组变化更为明显(P<0.05)。结论:慢性肥厚性鼻炎采用鼻内镜下鼻甲黏膜下骨质部分切除联合骨折外移术治疗较离子射频消融联合骨折外移术效果显著,对NCV和NAR改善明显,鼻黏膜损伤较小。Objective:To explore the clinical efficacy of combination of partial submucosal turbinate bone resection under nasal endoscope and fractured-bone removal in the treatment of chronic hypertrophic rhinitis and its influence on postoperative complications.Methods:One hundred and six patients with chronic hypertrophic rhinitis in Nanyang Central Hospital were selected as the research subjects.According to the random number table method,the patients were divided into observation group(53 cases)and control group(53 cases).The patients in the observation group underwent nasal endoscopic partial submucosal turbinate bone resection combined with fractured-bone removal,while the patients in the control group received plasma radiofrequency ablation combined with fractured-bone removal.The clinical efficacy,postoperative complications,nasal cavity volume(NCV),nasal airway resistance(NAR)and nasal mucosal status before surgery and 6 months after surgery were compared between the two groups.Results:There were no obvious differences in clinical effective rate and total incidence rate of complications between the two groups(P>0.05).Six months after surgery,the nasal minimal cross-sectional area(NMCA)and NCV were significantly increased in the observation group and the control group(P<0.05),while NAR was significantly decreased(P<0.05),and the ratio of ciliated cells to goblet cells and mucociliary transport rate(MTR)were significantly enhanced(P<0.05),and the changes were more obvious in the observation group(P<0.05).Conclusions:Partial submucosal turbinate bone resection under nasal endoscope combined with fractured-bone removal has a significant therapeutic effect on chronic hypertrophic rhinitis,which has significant improvements on NCV and NAR and small damage to nasal mucosa.

关 键 词：慢性肥厚性鼻炎 骨质切除 鼻腔容积 通气阻力 鼻腔黏膜 等离子射频消融 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]