鼻声反射和鼻阻力检查在鼻内镜下低温等离子射频消融术疗效评价中的临床意义

目的：探讨鼻声反射和鼻阻力（NR）检查作为鼻通气功能的客观检查方法，在鼻内镜下低温等离子射频消融术疗效评价中的临床意义。方法：应用鼻声反射仪和鼻阻力计对以持续性鼻阻塞为主要症状，经正规药物治疗后效果不明显或无效的106例（治疗组）中重度慢性鼻炎患者，于鼻内镜下低温等离子射频消融术前及术后6个月，分别在鼻黏膜收缩前和收缩后，进行鼻声反射及NR检查，记录NR、鼻腔最小横截面积（NMCA）、鼻腔最小横截面积距前鼻孔的距离（DCAN）、鼻腔平均横截面积（MNCA）及鼻腔容积（NCV）。另以36例健康人作为对照组，同样在鼻黏膜收缩前和收缩后，进行鼻声反射及NR检查，应用SAS6．12软件对2组数据进行统计学分析。结合患者的主观症状及视觉模拟量表（VAS）评分，对低温等离子射频消融术疗效进行评价。结果：术前治疗组NR明显高于对照组，NMCA明显低于对照组，差异均有统计学意义（均P〈0．01）。低温等离子射频消融术后治疗组有效率为100％，术后VAS评分均较术前降低，差异有统计学意义（P〈0．01）。治疗组术后NR较术前明显降低，NMCA较术前明显增大，差异有统计学意义（P％0．01）。同组内鼻黏膜收缩前和收缩后，NR和NMCA差异无统计学意义（P〉0．05）。治疗组术后NR和NMCA与对照组之间差异无统计学意义（P〉0．05）。结论：鼻内镜下低温等离子射频消融术对于中重度慢性鼻炎患者鼻通气功能的改善有显著疗效，鼻声反射和NR检杏能客观准确地评价低温等离子射频消融术的疗效。

Clinical significance of acoustic rhinometry and nasal resistance checks in the efficacy evaluation of low temperature radiofrequency ablation by nasal endoscopy

Objective： To study on clinical significance of acoustic rhinometry and nasal resistance checks by low temperature radiofrequency ablation on nasal endoscopy operation. Method： Application instrument of acoustic rhinometry and nasal resistance meter on 106 cases with moderate to severe persistent nasal obstruction symp toms. These patients are not obvious or invalid after regular drug treatment. The preoperative and postoperative six months,with the nasal mucosa contraction before and after by inspect respectively,also record nasal resistance （NR）, nasal minimum cross-sectional area（NMCA）, distance of the minimal cross sectional area to tile nostril （DCAN）, mean nasal cross sectional area（MNCA）, nasal cavity from volume（NCV） . The other 36 cases of healthy people as a control group. Before and after nasal mucosa contraction by inspect. Two sets of data were sta- tistically analyzed with SAS6.12. The efficacy evaluation of radiofrequency ablation by improve the extent and vis ual analog scale （VAS） score , with the patient ＇s subjective symptoms. Result：The group of preoperative rhinitis treatment NR higher than the controls significantly, the NMCA significantly lower than the control group（P〈 0.01） . The group of postoperative by radiofrequency ablation and rhinitis treatment was 100%, postoperative VAS scores were decreased compared with pre operative（P〈0.01） . The group of rhinitis treatment NR was sig nificantly lower than the preoperative, and NMCA significantly increased compared with the preoperative（P〈 0.01） . Before and after nasal contraction in the same group, NR and NMCA was no difference（P〈0.05）. The NR and NMCA of the postoperative in rhinitis treatment group was no difference compared with the control group （P〉0. 05）. Conclusion： Low temperature radio frequency ablation by nasal endoscopy operation had a significant improvement of nasal ventilation functions for patients with moderate to severe chronic rhinitis, acoustic rhinome try and nasal resistance can be an objective and accurate evaluation to this operation.