下鼻甲黏骨膜下部分切除术治疗慢性肥厚性鼻炎疗效探究
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摘要
目的探讨下鼻甲黏骨膜下部分切除术对慢性肥厚性鼻炎的治疗效果。方法收集本科收治的206例慢性肥厚性鼻炎患者,随机分为对照组及观察组,各103例,分别接受下鼻甲部分切除术或下鼻甲黏骨膜下部分切除术治疗。对两组治疗效果、手术指标、VAS评分、鼻自洁功能和安全性进行比较。结果观察组总有效率明显高于对照组,术中出血量、创面愈合时间以及术后渗血时间明显低于对照组(P<0.05),但手术时间更长;两组术后6个月鼻塞的VAS评分、鼻自洁功能均较术前改善,以观察组更显著(P<0.05);观察组不良反应发生率明显低于对照组(P<0.05)。结论下鼻甲黏骨膜下部分切除术对慢性肥厚性鼻炎具有疗效显著、损伤小、术后愈合快及鼻功能恢复佳等优点,值得临床推广。
Objective To explore the effects of ubmucosal partial resection of inferior turbinate in the treatment of chronic hypertrophic rhinitis. Methods A total of 206 patients with chronic hypertrophic rhinitis admitted to our department were selected and randomly divided into a control group and an observation group(n =103, respectively). The two groups were treated with partial inferior turbinectomy and ubmucosal partial resection of inferior turbinate respectively. The effects, operation indexes, VAS scores, nose self-cleaning function and safety between the two groups were compared. Results The overall response rate(ORR) in the observation group was significantly higher than that in the control group, and the amount of bleeding during operation, wound healing time and postoperative bleeding time were much less and shorter than those in the control group(P < 0.05), but the operation time was longer than that in the control group; six months after the operation, the VAS scores of nasal obstruction and nose self-cleaning function in the two groups were better than those before the operation, and the improvement in the observation group was more significant( P < 0.05);the incidence of adverse reactions in the observation group was significantly lower than that in the control group( P < 0.05). Conclusion Ubmucosal partial resection of inferior turbinate has such advantages as evident effects, minor injury, quick postoperative healing and sound recovery of nasal function in the treatment of chronic hypertrophic rhinitis, so it is worthy of clinical popularization.
Objective To explore the effects of ubmucosal partial resection of inferior turbinate in the treatment of chronic hypertrophic rhinitis. Methods A total of 206 patients with chronic hypertrophic rhinitis admitted to our department were selected and randomly divided into a control group and an observation group(n =103, respectively). The two groups were treated with partial inferior turbinectomy and ubmucosal partial resection of inferior turbinate respectively. The effects, operation indexes, VAS scores, nose self-cleaning function and safety between the two groups were compared. Results The overall response rate(ORR) in the observation group was significantly higher than that in the control group, and the amount of bleeding during operation, wound healing time and postoperative bleeding time were much less and shorter than those in the control group(P < 0.05), but the operation time was longer than that in the control group; six months after the operation, the VAS scores of nasal obstruction and nose self-cleaning function in the two groups were better than those before the operation, and the improvement in the observation group was more significant( P < 0.05);the incidence of adverse reactions in the observation group was significantly lower than that in the control group( P < 0.05). Conclusion Ubmucosal partial resection of inferior turbinate has such advantages as evident effects, minor injury, quick postoperative healing and sound recovery of nasal function in the treatment of chronic hypertrophic rhinitis, so it is worthy of clinical popularization.
引文
[1]Nguyen KH,Suzu ki H,Wakasugi T,et al.Expression of epidermal growth factors and a tight junction protein in the nasal mucosa of patients with chronic hypertrophic rhinitis[J].Allergologia Et Immunopathologia,2013,41(4):246-254.
[2]Kastner J,Kuchar M,Zábrodsky M,et al.Chronic hypertrophic rhinitis resistant to conservative therapy-comparison of various surgical techniques of mucotomy/turbinoplasty(including economic analysis)[J].Otorinolaryngologie A Foniatrie,2012,61(3):162-171.
[3]吴家森,殷海,刘柏松,等.慢性肥厚性鼻炎不同手术方式疗效观察[J].中国耳鼻咽喉头颈外科,2012,19(10):567-568.
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[5]Assanasen P,Banhiran W,Tantilipikorn P,et al.Combined radiofrequency volumetric tissue reduction and lateral outfracture of hypertrophic inferior turbinate in the treatment of chronic rhinitis:short-term and long-term outcome[J].International Forum of Allergy&Rhinology,2014,4(4):339-344.
[6]刘鹏,甄莹,孙德义,等.射频消融术治疗慢性肥厚性鼻炎[J].中国耳鼻咽喉头颈外科,2008,15(2):110-111.
[7]艾文彬,肖霞,罗志强,等.鼻内镜下等离子消融联合下鼻甲骨折外移治疗慢性肥厚性鼻炎105例[J].山东大学耳鼻喉眼学报,2011,25(2):51-53.
[8]邹胜琴,王定松.等离子射频消融与下鼻甲部分切除术治疗慢性肥厚性鼻炎疗效观察[J].成都医学院学报,2012,7(4):607-609.
[9]苗英章,魏欣,安慧琴,等.鼻内镜下功能性下鼻甲黏膜下切除术治疗慢性肥厚性鼻炎[J].现代中西医结合杂志,2011,20(36):4646-4648.
[10]黄靓.慢性肥厚性鼻炎手术方法的效果比较[J].中国煤炭工业医学杂志,2012,15(7):1022-1023.
[11]陈剑秋,朱春生,林家峰,等.3种不同术式治疗慢性肥厚性鼻炎的疗效分析[J].生物医学工程与临床,2011,15(2):169-172.
[12]李东平.黏膜下下鼻甲骨切除术治疗骨质增生型慢性肥厚性鼻炎[J].重庆医学,2012,41(26):2789-2790.
[2]Kastner J,Kuchar M,Zábrodsky M,et al.Chronic hypertrophic rhinitis resistant to conservative therapy-comparison of various surgical techniques of mucotomy/turbinoplasty(including economic analysis)[J].Otorinolaryngologie A Foniatrie,2012,61(3):162-171.
[3]吴家森,殷海,刘柏松,等.慢性肥厚性鼻炎不同手术方式疗效观察[J].中国耳鼻咽喉头颈外科,2012,19(10):567-568.
[4]卜国铉.耳鼻咽喉科全书.鼻科学[M].2版.上海:上海科学技术出版社,2001:40-46.
[5]Assanasen P,Banhiran W,Tantilipikorn P,et al.Combined radiofrequency volumetric tissue reduction and lateral outfracture of hypertrophic inferior turbinate in the treatment of chronic rhinitis:short-term and long-term outcome[J].International Forum of Allergy&Rhinology,2014,4(4):339-344.
[6]刘鹏,甄莹,孙德义,等.射频消融术治疗慢性肥厚性鼻炎[J].中国耳鼻咽喉头颈外科,2008,15(2):110-111.
[7]艾文彬,肖霞,罗志强,等.鼻内镜下等离子消融联合下鼻甲骨折外移治疗慢性肥厚性鼻炎105例[J].山东大学耳鼻喉眼学报,2011,25(2):51-53.
[8]邹胜琴,王定松.等离子射频消融与下鼻甲部分切除术治疗慢性肥厚性鼻炎疗效观察[J].成都医学院学报,2012,7(4):607-609.
[9]苗英章,魏欣,安慧琴,等.鼻内镜下功能性下鼻甲黏膜下切除术治疗慢性肥厚性鼻炎[J].现代中西医结合杂志,2011,20(36):4646-4648.
[10]黄靓.慢性肥厚性鼻炎手术方法的效果比较[J].中国煤炭工业医学杂志,2012,15(7):1022-1023.
[11]陈剑秋,朱春生,林家峰,等.3种不同术式治疗慢性肥厚性鼻炎的疗效分析[J].生物医学工程与临床,2011,15(2):169-172.
[12]李东平.黏膜下下鼻甲骨切除术治疗骨质增生型慢性肥厚性鼻炎[J].重庆医学,2012,41(26):2789-2790.