鼻内镜下单侧翼管神经切断术对变应性鼻炎合并哮喘的疗效观察

Clinical efficacy of endoscopic unilateral vidian neurectomy on allergic rhinitis with asthma

摘要:

目的评估鼻内镜下单侧翼管神经切断术治疗药物治疗效果不佳的变应性鼻炎(AR)合并哮喘患者的临床疗效。方法收集整理26例AR合并哮喘且均经鼻内镜下行单侧翼管神经切断术患者的临床资料，应用视觉模拟量表(VAS)、鼻结膜炎生存质量调查问卷(RQLQ)以及哮喘控制量表(ACT)来评估手术前后患者的生活质量。结果所有患者术后均随访3年以上，采用SPSS 21.0统计学分析，VAS评分和RQLQ平均得分术后6个月(10.00±4.22、32.58±15.31)、1年（8.35±6.88、28.62±12.06）、3年（7.46±4.22、28.69±5.66）均显著低于术前（24.34±8.66、59.81±21.20）；ACT评分术后6个月（22.65±1.52）、1年（22.27±2.27）及3年（22.85±2.38）均高于术前（20.92±2.64）,差异均具有统计学意义(P均<0.05)。结论鼻内镜下单侧翼管神经切断术对药物治疗效果不佳的AR合并哮喘患者疗效显著且持久，哮喘临床控制水平、用药量均保持稳定。

Abstract:

ObjectiveTo evaluate the clinical efficacy of endoscopic unilateral vidian neurectomy (EUVN) in the management of refractory allergic rhinitis (AR) with asthma.MethodsClinical data of 26 patients with refractory AR and asthma who underwent EUVN were reviewed retrospectively. Visual Analogue Scale (VAS) Questionnaire, Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ)，Asthma Control and Test (ACT) were utilized to evaluate their quality of life before and after surgery.ResultsAll the 26 patients had been followed up for more than 3 years. Postoperative scores (±s) of RQLQ and VAS at the time of 6 months (10.00±4.22, 32.58±15.31), one year (8.35±6.88, 28.62±12.06), 3 years (7.46±4.22, 28.69±5.66) were lower than the preoperative ones (24.34±8.66, 59.81±21.20), respectively. Postoperative scores (±s) of ACT at the time of 6 months (22.65±1.52), one year(22.27±2.27), 3 years (22.85±2.38) were higher than the preoperative score (20.92±2.64), respectively. All the differences were statistically significant (all P<0.05).ConclusionEUVN can improve AR with asthma significantly and persistently with stable asthma control level and antiasthma drug dose.