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。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例鼻内镜下行下鼻甲前端入路骨质部分切除联合黏膜内等离子消融术，即囊袋法下鼻甲成形术（A组）；61例鼻内镜下行下鼻甲骨折外移术联合黏膜外等离子消融术（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均＜0.05）；两组间术前与术后1个月鼻阻力值、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年各项比较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组术中出血量比较差异无统计学意义（P＞0.05），黏膜恢复时间比较差异具有统计学意义（P＜0.05）。两组下鼻甲黏液纤毛功能术前比较差异无统计学意义（P＞0.05），两组术后比较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 investigate the efficacy and postoperative complications of the pocket technique for inferior turbinoplasty in patients with chronic hypertrophic rhinitis. Methods A total of 126 patients with chronic hypertrophic rhinitis were enrolled to Changsha Hospital of Traditional Chinese Medicine. 65 of them underwent partial resection of the bone through the anterior inferior turbinate approach under nasal endoscopy combined with plasma ablation through mucosal incision, namely inferior turbinoplasty using the pocket technique(Group A). And 61 patients of them underwent external migration of the inferior turbinate fracture under nasal endoscopy combined with plasma radiofrequency ablation outside the mucosa (Group B). The two groups were compared for curative effects of treating chronic hypertrophic rhinitis. Results Before and after surgery, both groups were significantly reduced in the nasal resistance value, nasal endoscopic score, and VAS score (P<0.05); there was no statistically significant difference in nasal resistance values, nasal endoscopic scores, and VAS scores between the two groups before surgery and at 1 month postoperatively (P>0.05). At 1 year postoperatively, there was a significant difference (P<0.05). In Group A, there was no statistically significant difference in short-and long-term postoperative efficacy within the group (P>0.05). In Group B, there was a statistically significant difference in short- and long-term postoperative efficacy within the group (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). Preoperative inferior turbinate mucociliary function did not differ significantly between the two groups (P>0.05), whereas postoperative inferior turbinate mucociliary function differed significantly between the two groups (P<0.05). Conclusions The pocket technique inferior turbinoplasty provides effective improvement of nasal obstruction in chronic hypertrophic rhinitis. It is satisfactory for therapeutic efficacy in short-term and long-term, which is worthy of clinical promotion.