经鼻内窥镜蝶腭\筛前神经划痕术治疗常年性变应性鼻炎(1)
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【摘要】目的:探讨经鼻内窥镜蝶腭神经与筛前神经划痕术治疗变应性鼻炎的适应症、方法、临床疗效及应用价值。方法:纳入30例常年性变应性鼻炎患者,采用自身左右两侧鼻孔进行对照,观察蝶腭神经与筛前神经划痕术与翼管神经切断术两种方法治疗过敏性鼻炎的临床疗效及应用价值。结果:两种手术疗效相当,两年内均无复发,但蝶腭神经与筛前神经划痕术操作更容易、出血更少、时间更短、术后无眼干的副作用。结论:经鼻内窥镜蝶腭神经与筛前神经划痕术操作更容易,无副作用。
【关键词】鼻内窥镜;蝶腭神经;筛前神经;翼管神经;变应性鼻炎
doi:10.3969/j.issn.1006-1959.2010.09.008文章编号:1006-1959(2010)-09-2305-02
Treatment of perennial allergic rhinitis by sphenopalatine nerve and anterior ethmoidal nerve scarification with nasal endoscopeYU Xiao-xu,WANG Huai-fuDepartment of Otolaryngology,Sichuan Academy of Medical Sciences,Sichuan Provincial People's Hospital,Chengdu,610072,China
【Abstract】Objective:To study the indications,therapeutic effects,adverse reactions and manipulation of sphenopalatine nerve and anterior ethmoidal nerve scarification with nasal endoscope.Method:30 patients of perennial allergic rhinitis were included in this study.The therapeutic effects,adverse reactions,application value of sphenopalatine nerve and anterior ethmoidal nerve scarification were compared with those of vidianneurectomy.These two kinds of operations were carried out in different nosetrils of the same patient.Results:The therapeutic effects of those two treatments are equivalent.No recurrence occurred in two years,but it's easy to carry out the sphenopalatine nerve and anterior ethmoidal nerve scarification with no adverse reaction of eye exsiccation and less time and bleeding.Conclusion:It's easier to carry out the sphenopalatine nerve and anterior ethmoidal nerve scarification with nasal endoscope,without adverse reactions.
【Key words】Nasal endoscope;Sphenopalatine nerve;Anterior ethmoidal nerve;Otorhinolaryngologic surgical procedures;Allergic rhinitis
目前对于变应性鼻炎的治疗还没有理想的方法,抗组胺药物不能根治,脱敏治疗有效率较低,神经阻滞疗效不够持久。翼管神经手术偶可发生术中、术后出血,术后往往伴有眼干的副作用。笔者通过复习鼻腔神经血管的解剖,考虑同时切断蝶腭神经与筛前神经,应能取得理想疗效,而且避开了较大的血管,解剖位置浅,不应影响泪腺分泌。遂设计出“经鼻内窥镜蝶腭神经与筛前神经划痕术”,为评价该术式的疗效、副作用与可操作性,收集了30例常年变应性鼻炎患者,进行了自身左右两侧不同术式的随机对照研究,现报道如下:
1.对象和方法
1.1对象:所有患者均为2006年4月-2007年6月,于我科就诊的,符合常年性变应性鼻炎诊断标准[1]。共纳入30例,其中男16例,女14例,年龄21～50岁,平均年龄36岁。所有30例患者均无明显鼻中隔偏曲、鼻窦炎、鼻息肉等邻近器官疾病;无高血压、糖尿病等基础疾病。
1.2方法:
1.2.1随机方法:研究前先产生30个顺序号,每个号码代表一个患者,并产生30个随机的三位小数与之对应,末位数是0、2、4、6、8的行左侧“经鼻内窥镜蝶腭神经与筛前神经划痕术”,右侧“经鼻内窥镜翼管神经切断术”;末位数是1、3、5、7、9的反之。研究中符合条件的患者顺序入组,根据随机数字决定手术方式 ......
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