下鼻甲不同术式对鼻黏膜纤毛功能的影响

目的比较黏膜瓣下鼻甲成形术、黏膜下下鼻甲骨切除术、下鼻甲微波手术和传统下鼻甲部分切除术对鼻黏膜纤毛功能的影响。方法将慢性肥厚性鼻炎患者150例及正常对照者30例分3组。A组,一侧行黏膜瓣下鼻甲成形术(120例,120侧),另一侧分别行下鼻甲部分切除术(60例,60侧)和黏膜下下鼻甲骨切除术(60例,60侧);B组,30例(60侧)行下鼻甲微波手术;C组,30例(60侧)个体未行任何手术,做正常对照。用糖精试验分别测定术前及术后3个月黏膜纤毛传送时间,并进行统计学分析。结果黏膜瓣下鼻甲成形术与黏膜下下鼻甲骨切除术术后黏膜纤毛传送时间无明显差异(P>0.05),与正常相比无统计学差异(P>0.05);与正常相比较,传统下鼻甲部分切除术和微波下鼻甲手术术后黏膜纤毛传送时间明显延长(P<0.05;P<0.01)。结论黏膜瓣下鼻甲成形术与黏膜下下鼻甲骨切除术能保留鼻黏膜纤毛功能,下鼻甲部分切除术和微波手术均明显降低黏膜纤毛功能。

Influence of various turbinate operations on nasal mucociliary function

Objective To evaluate the effects of turbinatoplasty with mucosal flap,submucosal turbinatectomy,partial turbinatectomy and microwave ablation on nasal mucociliary function.Methods One hundred and fifty patients with chronic hypertropic rhinitis and 30 normal subjects were divided into three groups.In group A,turbinatoplasty with mucosal flap was applied on one side(120 cases,120 sides) and partial turbinatectomy(60 cases,60 sides) and submucosal turbinatectomy(60 cases,60 sides) on the other side;In group B,microwave ablation was applied to the inferior turbinate(30 cases,60 sides);In group C,patients who were not treated by any surgical techniques were the control subjects(30 cases,60 sides).Mucociliary function with saccharin was compared pre-and postoperatively at the third month.Results There were no significant differences in average saccharin transport time between sides with turbinatoplasty and sides with submucosal turbinatectomy postoperatively(P>0.05),and no statistical difference between two operations and the control subjects postoperatively(P>0.05);The average saccharin transport time in patients with partial turbinatectomy and microwave ablation was longer than in the control subjects postoperatively(P<0.05;P<0.01).Conclusion Turbinatoplasty with mucosal flap and submucosal turbinatectomy can preserve nasal mucociliary function.Partial turbinatectomy and microwave ablation can disturb nasal mucociliary function significantly.