低温等离子消融术与下鼻甲外移术治疗慢性肥厚性鼻炎的对比研究

目的探讨低温等离子消融术及下鼻甲外移术治疗慢性肥厚性鼻炎所致鼻塞的疗效,并对这两种方法进行比较。方法将160例有明显鼻塞症状的慢性肥厚性鼻炎患者随机分为实验组(n=92)及对照组(n=68),实验组采用低温等离子消融术处理双侧下鼻甲;对照组采用双侧下鼻甲外移术。所有患者使用视觉模拟评分表(VAS)评价术前及术后6个月鼻塞症状的主观感觉。并观察下鼻甲黏膜恢复情况及下鼻甲平面鼻腔间隙。结果实验组术后反应(鼻腔疼痛、鼻腔分泌物、下鼻甲肿胀)时间长于对照组,差异有显著性(P<0.01);两组术后鼻塞VAS评分均明显低于术前,差异有显著性(P<0.01);实验组鼻塞VAS评分在术后15天明显高于对照组,而术后6个月,实验组鼻塞VAS评分明显低于对照组,差异均有显著性(P<0.01);实验组下鼻甲平面鼻腔间隙在术后6个月明显大于对照组,差异有显著性(P<0.01)。结论低温等离子消融术和下鼻甲外移术在治疗慢性肥厚性鼻炎均有可靠的疗效;低温等离子消融术后反应较下鼻甲外移术重,但远期效果较下鼻甲外移术好。该两种方法均有很好的临床应用价值。

Comparision investigation of hypothermy plasma ablation with inferior turbinate displacement fracture in treatment of chronice hypertrophic rhinitis

Objectve To explore and compare the curative effect between hypothermy plasma ablation and inferior turbinate displacement fracture for the treatment of chronic hypertrophic rhinitis.Methods 160 cases of chronice hypertrophic rhinitis who had obviously nasal congestion were randomly divided into two groups.In the experimental group（n = 92）,hypothermy plasma ablation was applied to inferior turbinate.The contral group（n = 68） was given the inferior turbinate displacement fracture.Visual analogue scale（VAS） for subjective feeling of nasal congestion were obtained both before and after treatment for 15 d,1 month,3 month,and 6 month,and during the follow-up period.Their recovery of nasal mucosa and the flat nasal turbinate gap were evaluated.Results After postoperative,the time of reactions（nasal pain,nasal discharge,swelling of the inferior turbinate） in experimental group was longer than that of control group.The differences were statistically significant in both groups（P 0.01）.The postoperative nasal congestion and VAS scores were significantly lower than before surgery,the difference was statistically significant（P 0.01）.The nasal congestion VAS score of the experimental group was significantly higher than that of control group in the 15 days after surgery.However,6 months after surgery,nasal congestion VAS score of the experimental group was significantly lower than those of the control group,the differences were statistically significant（P 0.01）.Flat nasal turbinate gap in the experimental group was significantly larger than that of the control group after 6 months,the difference was statistically significant（P 0.01）.Conclusion Both hypothermy plasma ablation and inferior turbinate displacement fracture have definite curative effect to chronice hypertrophic rhinitis.However,in contrast to inferior turbinate displacement fracture,the hypothermy plasma ablation has obvious and serious reactions after treatment.The long-term effect of hypothermy plasma ablation is good than inferior turbinate displacement fracture.Both of them have important clinical application value.