鼻中隔四线减张矫正术治疗鼻中隔偏曲的疗效观察

Observation on the therapeutic effect of four-line tension-relaxing septoplasty for the treatment of nasal septum deviation

摘要:

目的 评估鼻中隔四线减张矫正术在治疗鼻中隔偏曲中的临床疗效。方法 回顾性分析2021年10月—2023年5月长沙市中医医院收治的56例鼻中隔偏曲患者的临床资料，患者均采用鼻中隔四线减张矫正术治疗，对患者手术前后的鼻阻力值和鼻部症状视觉模拟评分法（VAS）评分进行比较。结果 所有患者术后随访 1年，患者偏曲侧VAS评分（1.73±1.04）较术前（6.68±1.05）显著降低，差异具有统计学意义（t=24.971，P＜ 0.05）；鼻腔偏曲侧吸气鼻阻力值（0.85±0.17）Pa/(cm³·s)及呼气鼻阻力值（1.17±0.47）Pa/(cm^{3·s)较术前吸气鼻阻力（3.93±}0.75）Pa/(cm³·s)及呼气鼻阻力（3.01±0.63）Pa/(cm³·s)均显著改善（t=29.817、17.276， P均＜0.05）。鼻腔宽敞侧手术前后VAS评分及鼻阻力值比较，差异均无统计学意义（P均＞0.05）。结论 鼻中隔四线减张矫正术通过有效松解鼻中隔偏曲处张力，矫正偏曲畸形、改善患者鼻腔通气，达到鼻中隔偏曲矫正效果，并且远期疗效稳定，适合临床推广应用。

Abstract:

Objective To evaluate the clinical efficacy of four-line tension-relaxing correction for the treatment of nasal septum deviation.Methods Clinical data of 56 patients with nasal septum deviation admitted to Changsha Hospital of Traditional Chinese Medicine from October 2021 to May 2023 were retrospectively analyzed. All patients underwent four-line tension-relaxing septoplasty. The nasal resistance values and visual analogue scale (VAS) scores of nasal symptoms before and after the surgery were compared.Results One-year postoperative follow-up showed that the VAS score on the deviated side (1.73±1.04) was significantly lower than that before the operation (6.68±1.05), and the difference was statistically significant (t=24.971, P<0.05). The inspiratory nasal resistance value (0.85±0.17) Pa/(cm³·s) and expiratory nasal resistance value (1.17±0.47) Pa/(cm³·s) on the deviated side were significantly improved compared with those before the operation inspiratory (3.93±0.75) Pa/(cm³·s), expiratory (3.01±0.63) Pa/(cm³·s) (t= 29.817, 17.276, both P<0.05). There were no statistically significant differences in VAS scores and nasal resistance values on the spacious side of the nasal cavity before and after the operation (P>0.05).Conclusions The four-line tension-relaxing septoplasty effectively relieves the tension at the site of nasal septum deviation, corrects the deviation deformity and significantly alleviates nasal obstruction by thoroughly releasing deviational tension. It demonstrates stable long-term outcomes and is suitable for clinical application.