| 变应性鼻炎的外科手术治疗专家共识（2022，上海） |
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| 引用本文： | 余少卿,王向东,徐睿,陈建军,孟娟,杨钦泰,孟粹达,许元腾,谢志海,孙悦奇,许成利,王英,杨玉成,刘锋,张维天,赵可庆,唐隽,杨艳丽,陆美萍,邱前辉,杨贵,喻国冻,赵长青,左可军,石照辉,魏欣,叶惠平,孙斌,安云芳,孙亚男,曾明,许昱,巴罗,张天虹,王洪田,章如新,顾瑜蓉,谭国林,叶菁,李华斌,中国鼻病研究协作组. 变应性鼻炎的外科手术治疗专家共识（2022，上海）[J]. 中国耳鼻咽喉颅底外科杂志, 2022, 28(1): 7-17 |
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| 作者姓名： | 余少卿 王向东 徐睿 陈建军 孟娟 杨钦泰 孟粹达 许元腾 谢志海 孙悦奇 许成利 王英 杨玉成 刘锋 张维天 赵可庆 唐隽 杨艳丽 陆美萍 邱前辉 杨贵 喻国冻 赵长青 左可军 石照辉 魏欣 叶惠平 孙斌 安云芳 孙亚男 曾明 许昱 巴罗 张天虹 王洪田 章如新 顾瑜蓉 谭国林 叶菁 李华斌 中国鼻病研究协作组 |
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| 作者单位： | 同济大学附属同济医院 耳鼻咽喉头颈外科, 上海 200065;首都医科大学附属北京同仁医院 耳鼻咽喉头颈外科, 北京 100730;中山大学附属第一医院 耳鼻咽喉科医院, 广东 广州 510080;华中科技大学同济医学院附属协和医院 耳鼻咽喉科, 湖北 武汉 430022;四川大学华西医院 耳鼻咽喉头颈外科, 四川 成都 610041;中山大学附属第三医院 耳鼻咽喉头颈外科和变态反应(过敏)科, 广东 广州 510630;吉林大学中日联谊医院 耳鼻咽喉头颈外科, 吉林 长春 130033;福建医科大学附属第一医院 耳鼻咽喉科, 福建 福州 350004;中南大学湘雅医院 耳鼻咽喉头颈外科, 湖南 长沙 410008;中山大学附属第七医院 耳鼻咽喉科, 广东 深圳 518107;广西医科大学第二附属医院 耳鼻咽喉头颈外科, 广西 南宁 530007;郑州大学第一附属医院 鼻科, 河南 郑州 450052;重庆医科大学附属第一医院 耳鼻咽喉头颈外科, 重庆 400016;上海交通大学附属第六人民医院耳鼻咽喉头颈外科, 上海 200233;复旦大学附属眼耳鼻喉科医院 耳鼻咽喉科, 上海 200031;佛山市第一人民医院 耳鼻咽喉头颈外科, 广东 佛山 528000;昆明医科大学第一附属医院耳鼻咽喉科, 云南 昆明 650032;南京医科大学第一附属医院 耳鼻咽喉科, 江苏 南京 210029;广东省人民医院 耳鼻咽喉头颈外科, 广东 广州 510080;深圳市龙岗区中心医院 耳鼻咽喉科, 广东 深圳 518116;贵州医科大学附属医院 耳鼻咽喉科, 贵州 贵阳 550001;山西医科大学第二医院 耳鼻咽喉科, 山西 太原 030001;深圳市龙岗区耳鼻喉医院 耳鼻咽喉科 深圳市耳鼻咽喉研究所, 广东 深圳 518172;海南省人民医院 耳鼻咽喉科医院, 海南 海口 570311;贵州省人民医院 耳鼻咽喉科, 贵州 贵阳 550002;西安交通大学第二附属医院 耳鼻咽喉头颈外科病院, 陕西 西安 710004;哈尔滨医科大学附属第二医院 耳鼻咽喉头颈外科, 黑龙江 哈尔滨 150001;华中科技大学同济医学院附属同济医院 耳鼻咽喉头颈外科, 湖北 武汉 430030;武汉大学人民医院 耳鼻咽喉头颈外科, 湖北 武汉 430060;西藏自治区人民医院 耳鼻咽喉科, 西藏 拉萨 850000;哈尔滨医科大学附属第一医院 耳鼻咽喉头颈外科, 黑龙江 哈尔滨 150001;首都医科大学附属北京世纪坛医院 变态反应科, 北京 100038;复旦大学附属华东医院 耳鼻咽喉科, 上海 200040;中南大学湘雅三医院 耳鼻咽喉头颈外科, 湖南 长沙 410013;南昌大学附属第一医院 耳鼻咽喉头颈外科, 江西 南昌 330006 |
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| 基金项目： | 国家自然科学基金杰出青年基金（81725004）；国家自然科学基金（81670901，81873689，81873690，81870700，82071014，82171104，82171119，82171120，82101201）；上海市科委项目（20MC920200，19XD4010000）；上海市促进市级医院临床技能与临床创新能力三年行动计划项目（SHDC2020CR4090）；上海申康医学发展中心临床科技创新项目（SHDC12019X07）；上海市卫生健康委先进适宜技术推广项目（2019SY071）；四川省科技厅重点研发项目（2021YFS0036）；四川省人社厅留学人员回国科技活动项目择优资助（川人社函〔2020〕291号）；成都市科技局重点产业研发支撑计划（2021-YF05-00473-SN）；福建省自然科学基金面上项目（2020J01981）；福建省卫生教育联合攻关计划项目（2019-wj-25）。 |
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| 摘 要： | 变应性鼻炎（AR）是一种变应原致敏和激发引起的、有神经介质参与的特异性IgE介导的、Th2类型鼻黏膜慢性炎症。AR的外科手术作为二线治疗手段，能够有效改善顽固性鼻塞和鼻黏膜高分泌及高敏感性反应，临床上推荐酌情使用。但目前AR的外科手术还存在一些争议性问题，诸如适应证的选择、并发症规避及疗效评价等。有鉴于此，中国鼻病研究协作组召集国内中青年鼻科专家，基于临床经验和循证医学证据制订了AR的外科手术治疗专家共识。本共识从AR手术治疗历史、相关解剖与生理病理学原理等角度出发，系统总结了AR手术治疗中的相关机制、手术方式与适应证选择，以及并发症处理与注意事项等，旨在指导并规范临床医师开展AR外科手术治疗，以期进一步拓展AR的治疗方式并提高相应的治疗疗效。
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| 关 键 词： | 鼻炎,变应性 外科手术 副交感神经 不良反应 |
| 收稿时间： | 2022-01-16 |
Expert consensus on surgical management of allergic rhinitis(2022, Shanghai) |
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| YU Shaoqing,WANG Xiangdong,XU Rui,CHEN Jianjun,MENG Juan,YANG Qintai,MENG Cuid,XU Yuanteng,XIE Zhihai,SUN Yueqi,XU Chengli,WANG Ying,YANG Yucheng,LIU Feng,ZHANG Weitian,ZHAO Keqing,TANG Jun,YANG Yanli,LU Meiping,QIU Qianhui,YANG Gui,YU Guodong,ZHAO Changqing,ZUO Kejun,SHI Zhaohui,WEI Xin,YE Huiping,SUN Bin,AN Yunfang,SUN Yanan,ZENG Ming,XU Yu,BA Luo,ZHANG Tianhong,WANG Hongtian,ZHANG Ruxin,GU Yurong,TAN Guolin,YE Jing,LI Huabin,Chinese Rhinopathy Research Cooperation Group. Expert consensus on surgical management of allergic rhinitis(2022, Shanghai)[J]. Chinese Journal of Otorhinolaryngology-skull Base Surgery, 2022, 28(1): 7-17 |
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| Authors: | YU Shaoqing WANG Xiangdong XU Rui CHEN Jianjun MENG Juan YANG Qintai MENG Cuid XU Yuanteng XIE Zhihai SUN Yueqi XU Chengli WANG Ying YANG Yucheng LIU Feng ZHANG Weitian ZHAO Keqing TANG Jun YANG Yanli LU Meiping QIU Qianhui YANG Gui YU Guodong ZHAO Changqing ZUO Kejun SHI Zhaohui WEI Xin YE Huiping SUN Bin AN Yunfang SUN Yanan ZENG Ming XU Yu BA Luo ZHANG Tianhong WANG Hongtian ZHANG Ruxin GU Yurong TAN Guolin YE Jing LI Huabin Chinese Rhinopathy Research Cooperation Group |
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| Affiliation: | Department of Otolaryngology Head and Neck Surgery, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, China;Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China;Otorhinolaryngology Hospital, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China;Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China;Department of Otolaryngology Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu 610041, China;Department of Otolaryngology Head and Neck Surgery & Department of Allergy, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China;Department of Otolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Jilin University, Changchun 130033, China;Department of Otolaryngology, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, China;Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha 410008, China;Department of Otolaryngology, the Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen 518107, China;Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China;Department of Rhinology, the First Hospital of Zhengzhou University, Zhengzhou 450052, China;Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China;Department of Otolaryngology Head and Neck Surgery, Sixth People''s Hospital, Shanghai Jiaotong University, Shanghai 200233, China;Department of Otolaryngology, EENT Hospital, Fudan University, Shanghai 200031, China;Department of Otolaryngology Headand Neck Surgery the First People''s Hospital of Foshan City, Foshan 528000, China;Department of Otolaryngology, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China;Department of Otolaryngology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;Department of Otolaryngology Head and Neck Surgery, Guangdong Provincial People''s Hospital, Guangzhou 510080, China;Department of Otolaryngology, the Central Hospital of Shenzhen Longgang District, Shenzhen 518116, China;Department of Otolaryngology, Affiliated Hospital of Guizhou Medical University, Guiyang 550001, China;Department of Otolaryngology, the Second Hospital of Shanxi Medical University, Taiyuan 030001, China;Department of Otolaryngology, Longgang E. N. T Hospital and Shenzhen Key Laboratory of E. N. T, Institute of E. N. T, Shenzhen, 518172, China;Otolaryngology Hospital, Hainan General Hospital, Haikou 570311, China;Department of Otolaryngology, Guizhou Provincial Hospital, Guiyang 550002, China;Otolaryngology Head and Neck Surgery Center, the Second Affiliated Hospital of Xi''an Jiaotong University, Xi''an 710004, China;Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Harbin Medical University, Harbin 150001, China;Department of Otolaryngology Head and Neck Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China;Department of Otolaryngology Head and Neck Surgery, Renmin Hospital, Wuhan University, Wuhan 430060 China;Department of Otolaryngology, Tibet Autonomous Region People''s Hospital, Lasha 850000, China;Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China;Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China;Department of Otolaryngology, Huadong Hospital, Fudan University, Shanghai 200040, China;Department of Otolaryngology Head and Neck Surgery, Third Xiangya Hospital, Central South University, Changsha 410013, China;Department of Otolaryngology Head and Neck Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China |
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| Abstract: | Allergic rhinitis (AR) is a specific IgE mediated Th2 type chronic inflammation of nasal mucosa caused by allergen sensitization and stimulation with the participation of neurotransmitters. As a second-line treatment, surgery for AR can effectively relief intractable nasal congestion and nasal mucosal hypersecretion and hypersensitivity, which is recommended to be used as appropriate in clinic. However, there are still some controversial issues in AR surgery, such as the selection of surgical indications, avoidance of complications, and evaluation of efficacy. In view of this, the Chinese Rhinopathy Research Cooperation Group convened domestic young and middle-aged rhinology experts to formulate an expert consensus on surgical treatment of AR based on clinical experience and evidence-based medical evidence. This consensus systematically summarizes the relevant mechanisms, surgical methods and indication selection, as well as complication treatment and precaution in AR surgical treatment from the perspective of AR surgical treatment history, relevant anatomical and physiological and pathological principles, in order to guide and standardize clinicians to carry out AR surgical treatment, so as to further expand the treatment methods of AR and improve the corresponding therapeutic efficacy. |
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| Keywords: | Rhinitis, allergic Surgery Parasympathetic nerve Adverse reaction |
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