鼻内镜下等离子射频鼻后神经切断术治疗中重度变应性鼻炎疗效观察

Therapeutic effect of endoscopic plasma postnasal neurotomy for moderate to severe allergic rhinitis

摘要:

目的 探讨鼻内镜下等离子射频行鼻后神经切断治疗中重度持续性变应性鼻炎的疗效。方法 2015年1月—2018年1月收治中重度变应性鼻炎合并下鼻甲肥大患者80例，其中46例同时合并有鼻中隔偏曲，所有患者应用等离子射频行鼻后神经切断术，同时行下鼻甲成形术；对46例合并鼻中隔偏曲患者行鼻中隔矫正术，观察手术前后变应性鼻炎症状改善情况。结果 术后经随访1年有效率100%，2年有效率95%，3年有效率88.75%，患者术后1、2、3年VAS总评分均比术前明显好转，3年内随着年限延长，治疗有效率逐年下降，VAS总评分逐年上升（P<0.05）。结论 鼻内镜下等离子射频行鼻后神经切断联合鼻中隔矫正及下鼻甲成形术治疗中重度变应性鼻炎疗效确切，长期效果仍需要进一步研究。

关键词:变应性鼻炎;鼻后神经切断术;鼻甲成形术;鼻中隔矫正术;等离子止血技术

Abstract:

Objective To investigate the therapeutic effect of endoscopic plasma postnasal neurotomy for moderate to severe persistent allergic rhinitis (PAR).Methods Eighty patients with moderate to severe PAR and hypertrophy of inferior turbinate hospitalized in our department between Jan 2015 and Jan 2018 were included. Of them, 46 were simultaneously combined with nasal septal deviation. All patients underwent endoscopic plasma postnasal neurotomy and inferior turbinoplasty. Endoscopic nasal septoplasty was simultaneously performed in the 46 patients with nasal septal deviation. The postoperative improvements of AR symptoms were observed.Results Follow-up revealed that the effective rate was 100% in 1 year, 95% in 2 years, and 88.75% in 3 years postoperatively, The overall scores of visual analogue scale (VAS) in 1 year, 2 and 3 years got improved significantly compared with those before surgery. Within 3 years, the therapeutic effect got decreased with increase of total VAS score year by year(P<0.05).Conclusions Endoscopic plasma postnasal neurotomy combined with nasal septoplasty and inferior turbinoplasty is effective for moderate and severe PAR. However, the long-term effect still needs further study.

Key words:Allergic rhinitis;Postnasal neurotomy;Turbinoplasty;Nasal septoplasty;Plasma hemostasis technilogy