等离子射频消融治疗常年变应性鼻炎50例分析

目的 观察低温等离子射频消融术治疗常年性变应性鼻炎的临床疗效.方法 随机选取本院50例诊断为常年性变应性鼻炎的病例行等离子射频消融治疗.结果 经术后随访6个月,大部分患者均取得较满意的疗效,治愈率(90％).治疗后VAS评分与术前相比均差异有统计学意义(P＜0.01).结论 低温等离子射频消融术对常年性变应性鼻炎具有较好的疗效,且安全、微创、术后并发症少,易操作.     

低温等离子射频消融术辅以中药鼻腔冲洗治疗变应性鼻炎的观察与护理

目的：临床主要的治疗过敏性鼻炎的方法在某种方面都存在一定弊端。低温等离子是用于软组织微创手术的一项新技术,治疗变应性鼻炎具有方法简便、易操作,对鼻黏膜损伤小,保存黏膜纤毛功能的特点 方法：取2006年1月—2013年12月收治于我院耳鼻咽喉科行低温等离子射频消融术辅以中药鼻腔冲洗的患者559例 结果：本组559例变应性鼻炎经低温等离子射频消融治疗辅以中药鼻腔冲洗后349例症状得到明显改善,结论： 低温等离子射频消融术辅以中药鼻腔冲洗治疗比常规治疗好,它损伤小、出血少、恢复快,在实行低温等离子射频消融术治疗期间,正确有效的护理是保证治疗成功的关键。     

鼻用激素联合低温等离子射频消融术治疗常年变应性鼻炎的疗效观察

目的:探讨针对常年变应性鼻炎患者应用鼻用激素联合低温等离子射频消融术实施治疗的效果。方法:将我院接收并治疗的常年性变应性鼻炎108例患者随机等分为对照组和研究组。对照组实施鼻用激素治疗,研究组实施鼻用激素联合低温等离子射频消融术治疗。将两组患者的临床疗效相关情况予以对比。结果:同对照组相比,研究组患者的流涕、鼻塞以及鼻痒、喷嚏等相关临床症状评分均明显偏低(P0.05);研究组患者1月以及半年后临床治疗总有效率均明显超过对照组(P0.05)。结论:针对常年变应性鼻炎患者应用鼻用激素联合低温等离子射频消融术实施治疗,能够有效改善患者预后,可以产生良好的近期以及远期疗效,具有推广应用价值。     

等离子筛前神经阻断术联合下鼻甲消融术治疗常年性变应性鼻炎的疗效

目的探讨鼻内镜下等离子筛前神经阻断术联合双下鼻甲消融术治疗常年性变应性鼻炎的临床疗效。方法对46例常年性变应性鼻炎患者采用鼻内镜下等离子筛前神经阻断术联合双下鼻甲消融术治疗。观察46例患者术后有无并发症发生及临床疗效等情况。结果 46例患者术后随访5个月～1年,显效28例（60.9%）,有效14例（30.4%）,无效4例（8.7%）;总有效率为91.3%。术后前3～5 d有局部水肿、渗出和鼻塞、流涕加重及前额部疼痛。无其他手术并发症发生。结论采用鼻内镜下等离子筛前神经阻断术联合双下鼻甲消融术治疗常年性变应性鼻炎疗效显著,是治疗常年性变应性鼻炎理想术式。     

鼻内镜下等离子治疗肥厚性鼻炎78例分析

目的:探讨鼻内窥镜下低温射频等离子消融治疗慢性肥厚性鼻炎的疗效。方法:对78例低温射频等离子消融治疗慢性肥厚性鼻炎的病例资料进行分析和患者的治疗效果观察评估。结果:在78例行等离子射频消融治疗的患者,总有效率为96.15%。结论:鼻内窥镜下低温射频等离子消融治疗慢性肥厚性鼻炎,是安全、有效、准确的治疗方法,临床观察疗效显著,达到了即时消融、微创,值得推广。     

低温等离子消融系统治疗变应性鼻炎病人的围术期护理

变应性鼻炎是指在变应原作用下经免疫学机制产生的鼻黏膜变态反应性炎症。本病以鼻痒、多次阵发性喷嚏、大量水样鼻涕和鼻塞为临床表现。分为季节性和常年性两种类型。以往采用手术、微波、激光等治疗方法,均破坏了鼻黏膜的结构、影响鼻腔的生理功能。近几年,我科采用低温等离子消融系统治疗变应性鼻炎46例,效果较满意。现将护理报告如下。     

鼻内镜下联合手术治疗变应性鼻炎合并鼻中隔偏曲

目的探讨鼻内镜下鼻中隔矫正术联合低温等离子射频消融术治疗常年性变应性鼻炎伴鼻中隔偏曲的临床效果。方法126例变应性鼻炎伴鼻中隔偏曲患者在鼻内镜下行联合手术治疗,术后随访1年。按照海口会议标准,用计分法评定其疗效。结果显效62.7%(79/126),有效30.2%(38/126),无效7.1%(9/126)。疗效评分显示治疗前为(11.34±2.17)分,治疗1年后为(6.71±1.86)分,二者相比差异有显著性(P<0.05)。结论鼻内镜下鼻中隔矫正术与低温等离子射频消融术联用治疗变应性鼻炎伴鼻中隔偏曲具有视野好、出血少、安全、疗效佳等优点,有较高的临床应用价值。     

鼻内镜等离子筛前神经切断加下鼻甲消融治疗变应性鼻炎的观察与护理

[目的]探讨鼻内镜等离子筛前神经(anterior ethmoid nerve)切断加下鼻甲消融治疗变应性鼻炎(PAR)的疗效。[方法]对试验组56例药物治疗不能控制症状的常年性PAR采用鼻内镜等离子筛前神经切断加下鼻甲消融治疗,并将其疗效与同期收治的药物治疗不能控制症状的对照组34例行单纯鼻中隔黏膜下矫正术治疗的常年性PAR病人的疗效进行比较。[结果]术后6个月、1年试验组与对照组总有效率比较有统计学意义(P<0.01)。[结论]鼻内镜等离子筛前神经切断加下鼻甲消融治疗PAR,具有术区定位准确,副反应少等优点,疗效显著优于单纯鼻中隔黏膜下矫正术治疗。加强术前心理护理及术后护理,对手术成功起着促进作用。     

鼻内镜等离子筛前神经切断加下鼻甲消融治疗变应性鼻炎的观察与护理

[目的]探讨鼻内镜等离子筛前神经（anterior ethmoid nerve）切断加下鼻甲消融治疗变应性鼻炎（PAR）的疗效。[方法]对试验组56例药物治疗不能控制症状的常年性PAR采用鼻内镜等离子筛前神经切断加下鼻甲消融治疗，井将其疗效与同期收治的药物治疗不能控制症状的对照组34例行单纯鼻中隔黏膜下矫正术治疗的常年性PAR病人的疗效进行比较。[结果]术后6个月、1年试验组与对照组总有效率比较有统计学意义（P〈0．01）。[结论]鼻内镜等离子筛前神经切断加下鼻甲消融治疗PAR，具有术区定位准确，副反应少等优点，疗效显著优于单纯鼻中隔黏膜下矫正术治疗。加强术前心理护理及术后护理，对手术成功起着促进作用。     

鼻内窥镜下射频治疗常年性变应性鼻炎的临床研究

目的 探讨提高难治性、顽固性常年性变应性鼻炎效果的方法。方法 利用鼻内窥镜下射频热凝治疗常年性变应性鼻炎患者80例，随访1年。结果 80例病例中，显效64例(80．0％)，有效6例(7．5％)，总有效率为87．5％。结论 鼻内窥镜下射频治疗PAR疗效显著、视野清楚、操作方便，具有较好的临床应用价值。     

鼻腔结构矫正结合射频治疗常年性变应性鼻炎

目的：观察鼻内镜手术结合射频治疗伴有鼻腔结构异常的常年性变应性鼻炎的疗效。方法：46例伴有鼻中隔偏曲或下鼻甲肥大的常年性变应性鼻炎患者，在鼻内镜下行鼻中隔黏膜下矫正术或下鼻甲黏膜下部分切除术，同时结合射频热凝下鼻甲、鼻丘、与鼻丘对应的鼻中隔等副交感神经密集部位。结果：术后随访1年以上，术后1个月和术后1年的总有效率分别为97．8％、82．6％。7例复发，其中6例发生在手术6个月以后。结论：对伴有鼻中隔偏曲或下鼻甲肥大的常年性变应性鼻炎患者，鼻内镜手术结合射频治疗是理想的治疗方法，术后复发多在6个月以后。     

变应性鼻炎血清总IgE水平测定及临床意义

目的研究血清总IgE在季节性与常年性变应性鼻炎中的变化,并探讨其临床意义。方法采用酶联免疫法检测62例变应性鼻炎患者和20例健康者血清总IgE水平,并进行相关性分析。结果季节性和常年性变应性鼻炎血清总IgE明显高于健康对照组(P<0.01),季节性变应性鼻炎血清总IgE明显高于常年性变应性鼻炎(P<0.01)。季节性变应性鼻炎症状和体征高于常年性,差异有统计学意义(P<0.05)。结论血清总IgE水平与变应性鼻炎的发作强度呈正相关,有助于临床诊断及病情评估。     

常年性变应性鼻炎成年患者屋尘螨的免疫治疗

目的:目的:探讨屋尘螨免疫治疗对上海地区常年性变应性鼻炎成年患者治疗的有效性和安全性。方法:采用患者自身用药前后对照设计。38例受试者为复旦大学附属中山医院耳鼻喉科门诊变应性鼻炎成年患者,采用屋尘螨提取液(阿罗格,默克公司,德国)进行53周疗程的皮下注射免疫治疗。观察患者血清IgE、IgG变化;皮肤点刺试验风团大小的变化;患者自我感觉症状的改善程度以及治疗的不良反应。结果:屋尘螨免疫治疗1年后血清IgE变化不明显,IgG有明显升高;皮肤试验反应降低,风团减小;患者自我评估明显改善;不良反应发生率低,没有严重不良反应。     

高压氧治疗常年性变应性鼻炎的临床及实验研究

目的 探讨高压氧治疗常年性变应性鼻炎的疗效及机理。方法 大、小鼠在压力为0．25MPa的高压氧舱内,每日2h,连续5或10d,进行免疫指标测定。30例常年性变应性鼻炎患者,在0．2MPa压力下的高压氧舱内吸纯氧,每日2h,连续20d,进行疗效评定。结果 吸高压氧后大鼠同种被动皮肤过敏反应受抑制（P＜0．01）;小鼠耳异种被动皮肤过敏反应受抑制（P＜0．01）;酪蛋白引起脱颗粒的小鼠腹腔肥大细胞数与对照组比较明显减少（P＜0．01）。30例患者治疗前后症状、体征比较,近期疗效99％,随访3年有效率达74％。结论 高压氧对实验动物Ⅰ型变态反应有显著抑制作用,对常年性变应性鼻炎是一种效果好、疗效稳定、无副作用的新治疗方法。     

Absorption across the nasal airway mucosa in house dust mite perennial allergic rhinitis

House dust mite allergens express protease activity and it has been suggested that this property has pathogenic effects by increasing airway absorption. In accordance, house dust mite allergens may increase mucosal permeability in vitro. The objective of the present study was to examine nasal absorption of desmopressin (1-deamino-8-D-arginine vasopressin) in patients with perennial house dust mite allergic rhinitis and in healthy subjects in vivo. Patients with perennial allergic rhinitis were examined after a 4-week treatment withdrawal period, when symptoms of allergic rhinitis occurred, and healthy subjects were examined together with the patients. Desmopressin (20 microg ml(-1)) was moved into the nasal cavity using a nasal pool-device that contained 15 ml fluid. The fluid was kept in the nasal cavity for 15 min and then recovered. Urine was collected for 24 h after the nasal administration and the urinary excretion of desmopressin was determined as an index of nasal absorption. The urinary excretion of desmopressin was 1148+/-535 pmol 24 h(-1) in patients with perennial house dust mite allergic rhinitis and 1012+/-291 pmol 24 h(-1) in healthy subjects. We conclude that nasal airway absorption of the 1067 Da peptide desmopressin is unaffected in perennial house dust mite allergic rhinitis compared with healthy subjects.     

Non-allergic perennial rhinitis

Non-allergic perennial rhinitis is a common disease occurring with the same frequency as perennial allergic rhinitis. It has long been a misunderstood clinical entity and this fact is reflected in the variety of names it has been given in the past. The understanding of the disease is still very incomplete such that it still remains a diagnosis of exclusion. Non-allergic perennial rhinitis usually responds well to medical treatment. Surgical management is reserved for those subjects who fail to respond satisfactorily to such measures and is particularly effective at treating refractory nasal obstruction. The following review discusses the classification, aetiology and treatment of this complex and perplexing condition.     

聚焦超声治疗68例中重度常年变应性鼻炎疗效观察

目的观察聚焦超声治疗仪治疗变应性鼻炎的效果。方法采用聚焦超声治疗仪治疗68例中重度常年变应性鼻炎患者,观察临床疗效。结果随访半年,显效28例,有效31例,无效9例,总有效率86.7%;治疗前后症状体征总积分及各症状评分比较,差异均有统计学意义（P〈0.05）。结论聚焦超声的近期疗效明显、副作用少,是变应性鼻炎治疗的有效方法。     

Previous ear, nose and throat surgery in children presenting with allergic perennial rhinitis

Children with allergic perennial rhinitis had a four-fold greater likelihood of having had an ear, nose and throat (ENT) operation than children with orthopaedic problems. Whilst the patients who had ENT operations had significantly lower serum IgA and IgE levels than the non-operated patients, there was no difference in clinical features of atopy or allergy skin-test responses between the two groups of rhinitic patients. Forty per cent of the perennial rhinitics had an improvement in symptoms following ENT operations, whereas 90% improved on medical therapy. Thus, patients with perennial rhinitis should have allergy investigations and the benefit of medical treatment prior to consideration for surgery.     

Double-blind comparison of cetirizine and loratadine in children ages 2 to 6 years with perennial allergic rhinitis.

Antihistamines are the pharmacologic cornerstone of treatment for allergic rhinitis. The comparative effects of the newer, more specific H (1) -antagonists cetirizine and loratadine among younger patients are not well characterized. The efficacy and safety of cetirizine and loratadine were compared in a prospective, randomized, double-blind, longitudinal, parallel-group study of 80 children, 2 to 6 years of age, with perennial allergic rhinitis caused by house dust mites or plant pollens (verified by a radioallergosorbent or skin test). Patients received cetirizine or loratadine at 0.2 mg/kg once daily in the morning for 28 days. Histamine skin tests and eosinophil counts from nasal smears were performed at baseline and at the end of treatment. Individual rhinitis symptoms were assessed by the investigator at baseline and on day 28 and by parents at baseline and daily in symptom diaries. Global assessments were made by using a visual analog scale at baseline and at the end of treatment. Cetirizine produced significantly greater inhibition of the wheal response compared with loratadine (P <.0001). Eosinophil counts were improved to a comparable degree with both agents. Cetirizine and loratadine produced comparable improvements in symptoms and according to a global evaluation as assessed by the investigator at the end of treatment. Both agents produced substantial symptomatic relief according to patients' daily diary assessments; however, cetirizine was more effective than loratadine in relieving the symptoms of rhinorrhea, sneezing, nasal obstruction, and nasal pruritus (P <. 0001). Both treatments were well tolerated; two patients receiving cetirizine were dropped from the study because of adverse events. Cetirizine and loratadine provided effective, well-tolerated relief of the symptoms of perennial allergic rhinitis in small children. Cetirizine was more effective than loratadine in inhibiting the wheal response to histamine challenge and afforded greater reductions in most individual symptoms assessed daily by the parent.     

特异性抗原免疫疗法治疗变应性鼻炎的疗效分析

目的：探讨特异性抗原免疫治疗变应性鼻炎的疗效和安全性。方法：87例根据典型临床症状、体征，经过敏原点剌试验、血清尘螨特异性IgE测定、血清ECP检测确诊为常年性变应性鼻炎的患者给予粉尘螨注射液皮下注射1次／周，观察患者症状、体征变化，评定疗效；同时观察患者不良反应情况。结果：87例常年性变应性鼻炎患者经粉尘螨注射液免疫治疗，总有效率90．80％；显效率67．81％（其中症状消失者达55．17%）；无效率9．19％。无严重不良反应。结论：应用粉尘螨抗原制剂对变应性鼻炎患者进行免疫治疗，正确掌握适应证和方法，疗效良好、安全。