慢性肥厚性鼻炎4种术式特点及下鼻甲黏膜的超微结构观察

目的：探讨治疗慢性肥厚性鼻炎4种不同术式的手术特点及下鼻甲黏膜超微结构的变化。方法：88例慢性肥厚性鼻炎患者行鼻内镜下鼻甲黏膜下成形术（A组），30例行下鼻甲部分切除术（B组），36例行射频消融下鼻甲减容术（C组），10例行下鼻甲硬化剂注射术（D组）。分别比较A、B、C3组术式治疗慢性肥厚性鼻炎的有效率、手术特点及术前、术后下鼻甲黏膜超微结构特征。结果：术后随访4～6个月，A、B、C3组的有效率分别为97．4％、100．0％和93．4％，差异无统计学意义（均P〉0．05）。A组和C组术式优点突出，下鼻甲黏膜纤毛结构保存较好。结论：鼻内镜下鼻甲黏膜下成形术和射频消融下鼻甲减容术是治疗慢性肥厚性鼻炎较好的手术方法。

The features of four types of operation for treating chronic hypertrophy rhinitis and ultrastructure observation of the inferior turbinate mucosa

OBJECTIVE: To assess the features of four types of operation for treating chronic hypertrophy rhinitis and to observe the ultrastructure of inferior turbinate mucosa. METHOD: Eighty-eight cases of chronic hypertrophic rhinitis (HR) were treated by transnasal endoscopic submucous inferior turbinate resection (group A), thirty cases of HR were treated by partial inferior turbinectomy (group B), thirty six cases of HR were treated by bipolar radiofrequency ablation on inferior turbinate (group C), ten cases of HR were treated by injection of sclerosing agent (group D). The efficacy in the three groups (A,B,C) and the features of four types operation were compared and the ultrastructure of inferior turbinate was observed both preoperatively and postoperatively. RESULT: Four groups of HR were followed up 4 months to half year after operation, effective rate was 97.4 (group A) 100% (group B) and 93.4% (group C) respectively, while group A, group B and group C effective rate had no significant difference among them. Group A and group C have more advantages compared to the other 2 groups for they remained good ultrastructure of inferior turbinate mucosal cilia after 4 to 6 months postoperatively. CONCLUSIONS: The use of transnasal endoscopic submucous inferior turbinate resection and bipolar radiofrequency ablation for treatment of chronic hypertrophy rhinitis are effective modality for the treatment of chronic hypertrophy rhinitis.