囊袋法下鼻甲成形术在慢性肥厚性鼻炎中的应用

Application of the Pocket Technique for Inferior Turbinoplasty in Chronic Hypertrophic Rhinitis

摘要:

目的 探讨囊袋法下鼻甲成形术在慢性肥厚性鼻炎中的疗效及术后并发症分析。方法 选取长沙市中医医院慢性肥厚性鼻炎患者126例并随机分组。65例采用囊袋法下鼻甲成形术（A组），即鼻内镜下经下鼻甲前端黏膜切口，沿骨面行黏膜下分离，形成囊袋状腔隙，经该腔隙暴露下鼻甲骨并行部分骨质切除、磨平及压平外移，再经原切口行黏膜内等离子消融；61例采用鼻内镜下行下鼻甲骨折外移术联合等离子黏膜外射频消融术（B组）。比较两组慢性肥厚性鼻炎患者的疗效。结果 两组组内术前与术后比较，鼻阻力值、鼻内镜评分及视觉模拟评分法（VAS）评分均显著降低（P＜0.05）；两组间术前与术后1个月时鼻阻力值、鼻内镜评分及VAS评分比较差异无统计学意义（P＞0.05），而术后1年时差异具有统计学意义（P＜0.05）；A组组内比较术后近、远期疗效差异无统计学意义（P＞0.05），B组组内比较术后近、远期疗效差异具有统计学意义（P＜0.05）。A组和B组手术出血量差异无统计学意义（P＞0.05），黏膜恢复时间差异具有统计学意义（P＜0.05）。结论 囊袋法下鼻甲成形术是改善慢性肥厚性鼻炎鼻塞的有效方法，近、远期疗效均比较理想，值得临床推广。

Abstract:

Objective To analysis of the efficacy and postoperative complications of the pocket technique inferior turbinoplasty in chronic hypertrophic rhinitis. Methods A total of 126 patients with chronic hypertrophic rhinitis in Changsha Hospital of Traditional Chinese Medicine were randomly divided into two groups. Sixty-five patients underwent the pocket technique for inferior turbinoplasty (Group A). Briefly, under nasal endoscopy, a mucosal incision was made at the anterior inferior turbinate, and submucosal dissection was performed along the bone to create a pocket-like space. The inferior turbinate bone was then exposed for partial resection, milling and flattening-lateralization, and intramucosal plasma ablation was performed through the same incision. Sixty-one patients underwent endoscopic inferior turbinate fracture-lateralization combined with extramucosal plasma radiofrequency ablation (Group B). The curative effects of the two groups were compared. Results Before and after surgery, the nasal resistance value, nasal endoscopic score, and VAS score were significantly reduced in both groups (P<0.05); There was no statistically significant difference in nasal resistance values, nasal endoscopic scores, and VAS scores between the two groups before and 1 month after surgery (P>0.05), but there was a statistically significant difference at 1 year after surgery (P<0.05); There was no statistically significant difference in the short-term and long-term postoperative efficacy between group A (P>0.05), while there was a statistically significant difference in the short-term and long-term postoperative efficacy between group B (P<0.05). There was no statistically significant difference in surgical bleeding between Group A and Group B (P>0.05), but there was a statistically significant difference in mucosal recovery time (P<0.05). ConclusionThe Pocket Technique inferior turbinoplasty provides effective improvement of nasal obstruction in chronic hypertrophic rhinitis, with satisfactory short-term and long-term efficacy, and is worthy of clinical promotion.